CMS Formulary

Displaying 17811-17820 of 1611142 results.
ID: 17811
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 979099
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17812
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 967023
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17813
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 967012
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17814
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 198332
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17815
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 197702
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17816
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1736047
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 17817
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1736050
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 17818
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1736053
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 17819
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1736044
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 17820
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 312845
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0