CMS Formulary

Displaying 16701-16710 of 1611142 results.
ID: 16701
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 309374
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 135
Qty Limit Days: 30
ID: 16702
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1299917
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 16703
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 995218
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 16704
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 866090
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 16705
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 643066
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 16706
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1652084
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 16707
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1006801
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 16708
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 996921
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 16709
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 721773
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 16710
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 476179
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30