CMS Formulary

Displaying 17921-17930 of 1611142 results.
ID: 17921
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 597772
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17922
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 403975
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17923
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 259306
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17924
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1799654
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17925
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 105292
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17926
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 2053458
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17927
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 199592
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 17928
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 805464
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 17929
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659927
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17930
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 2046585
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30