CMS Formulary

Displaying 17761-17770 of 1611142 results.
ID: 17761
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 313115
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17762
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 239240
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17763
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 809871
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 20
Qty Limit Days: 30
ID: 17764
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 864661
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17765
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 2001424
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17766
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1363408
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 17767
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1363410
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 17768
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364581
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 17769
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790175
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 17770
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790167
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30