CMS Formulary

Displaying 16051-16060 of 1611142 results.
ID: 16051
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 199888
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 16052
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 151226
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 16053
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 199889
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 16054
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 311486
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 16055
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 904396
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 16056
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 199672
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 16057
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 252559
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 16058
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 239238
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 16059
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 602393
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 16060
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 432402
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30