CMS Formulary

Displaying 17771-17780 of 1611142 results.
ID: 17771
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790171
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 17772
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1928941
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 17773
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 197703
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17774
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1300783
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17775
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 831261
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17776
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 829500
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17777
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 861025
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 765
Qty Limit Days: 30
ID: 17778
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 881341
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17779
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 199690
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17780
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 197417
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0