CMS Formulary

Displaying 16221-16230 of 1611142 results.
ID: 16221
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1591943
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 16222
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1799212
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 16223
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659183
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 16224
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659161
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 16225
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2467571
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 16226
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2467575
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 16227
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2472789
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 16228
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2478450
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 16229
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2369403
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 16230
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1594673
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0