CMS Formulary

Displaying 17801-17810 of 1611142 results.
ID: 17801
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 848742
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 17802
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 848746
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 17803
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 848750
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 17804
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 848730
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 17805
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 848734
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 17806
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 848752
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17807
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1491624
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 17808
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 2468316
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 17809
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 2381144
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17810
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 465355
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0