CMS Formulary

Displaying 17841-17850 of 1611142 results.
ID: 17841
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 577127
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 17842
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 403908
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17843
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 198038
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17844
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 198039
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17845
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 198040
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17846
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1010600
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 17847
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1307056
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 17848
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1010604
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 17849
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 198182
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17850
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 351223
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28