CMS Formulary

Displaying 16611-16620 of 1611142 results.
ID: 16611
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923056
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 70
Qty Limit Days: 28
ID: 16612
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923058
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 28
ID: 16613
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 2002719
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 16614
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058981
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 16615
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123314
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 16616
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 2121096
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 16617
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 2121100
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 16618
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 2390954
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 16619
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 545293
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 16620
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 207029
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0