CMS Formulary

Displaying 16481-16490 of 1611142 results.
ID: 16481
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1601390
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 16482
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1987734
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 16483
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058922
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 16484
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 2103175
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 16485
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 2103179
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 16486
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 810075
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 16487
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 810079
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 16488
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 2284108
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 16489
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 2057205
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 16490
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 2057216
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0