CMS Formulary

Displaying 16581-16590 of 1611142 results.
ID: 16581
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1603361
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 16582
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1603365
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 16583
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1603369
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 16584
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1656346
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 16585
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1425110
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 16586
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1425118
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 16587
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 867506
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 16588
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1425230
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 16589
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1425228
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 16590
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1245003
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30