CMS Formulary

Displaying 17711-17720 of 1611142 results.
ID: 17711
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 200082
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17712
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 199663
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17713
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 905199
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17714
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 905225
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17715
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 905395
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17716
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 198371
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17717
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 197817
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 17718
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 197818
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 17719
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 197889
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17720
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 855172
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0