CMS Formulary

Displaying 17931-17940 of 1611142 results.
ID: 17931
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 403878
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 17932
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1098143
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17933
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 2200174
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 17934
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 2200177
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 17935
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 2200180
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 17936
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 2200183
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 17937
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1648755
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 17938
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 725021
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 17939
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 725023
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 17940
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 311994
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30