CMS Formulary

Displaying 17621-17630 of 1611142 results.
ID: 17621
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 861004
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 75
Qty Limit Days: 30
ID: 17622
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 861731
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 17623
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 562524
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17624
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1652673
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17625
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650142
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17626
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 353538
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17627
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 897666
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17628
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099288
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17629
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099300
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17630
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099304
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0