CMS Formulary

Displaying 17751-17760 of 1611142 results.
ID: 17751
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 200284
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17752
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 312076
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 17753
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 351108
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 17754
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 349251
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17755
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 905041
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 17756
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 905092
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 17757
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 905100
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 17758
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1095712
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17759
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665515
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17760
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1719286
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0