CMS Formulary

Displaying 16231-16240 of 1611142 results.
ID: 16231
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 905059
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 16232
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 905064
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 84
ID: 16233
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 905057
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 168
ID: 16234
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1251334
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 16235
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1487076
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 224
Qty Limit Days: 28
ID: 16236
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1368459
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 16237
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 751970
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 16238
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 836358
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 312
Qty Limit Days: 30
ID: 16239
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1191250
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 16240
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 207373
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0