CMS Formulary

Displaying 17581-17590 of 1611142 results.
ID: 17581
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 312962
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 17582
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 349332
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17583
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 351250
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17584
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 856834
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17585
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 856845
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17586
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 856853
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17587
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 856762
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17588
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 856773
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17589
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 429503
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17590
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 310798
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0