CMS Formulary

Displaying 17671-17680 of 1611142 results.
ID: 17671
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 862025
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17672
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665102
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17673
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1737578
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17674
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659283
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17675
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659287
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17676
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 242800
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17677
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1721315
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17678
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1721314
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17679
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1361574
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17680
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 616539
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30