CMS Formulary

Displaying 17721-17730 of 1611142 results.
ID: 17721
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 242679
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17722
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 309313
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 600
Qty Limit Days: 30
ID: 17723
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 351285
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17724
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123194
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 17725
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 313565
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17726
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 313564
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17727
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 199885
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17728
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 242438
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17729
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 200094
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17730
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 200095
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0