CMS Formulary

Displaying 16251-16260 of 1611142 results.
ID: 16251
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364494
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 16252
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1648772
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 16253
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2046597
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 228
Qty Limit Days: 14
ID: 16254
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1989117
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 16255
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2178792
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 16256
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 644304
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 16257
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 861659
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 16258
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 861661
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 16259
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 861663
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 16260
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 545278
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0