CMS Formulary

Displaying 17691-17700 of 1611142 results.
ID: 17691
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 198428
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17692
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 198429
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17693
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 152695
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17694
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 854905
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17695
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 854901
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17696
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 313762
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 17697
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 313761
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 17698
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 884173
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17699
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 884185
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17700
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 884189
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0