CMS Formulary

Displaying 16241-16250 of 1611142 results.
ID: 16241
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1245268
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 16242
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 314088
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 16243
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 403914
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 16244
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 885209
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 16245
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1922765
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 16246
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1922763
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 16247
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 105553
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 16248
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 105590
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 16249
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364498
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 45
Qty Limit Days: 30
ID: 16250
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364490
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30