CMS Formulary

Displaying 16021-16030 of 1611142 results.
ID: 16021
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 855657
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 16022
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1812011
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 16023
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1812013
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 16024
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 562806
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 30
ID: 16025
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 825130
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 16026
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 861668
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 16027
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 831359
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 16028
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 801957
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 16029
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 801961
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 16030
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 801966
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0