CMS Formulary

Displaying 16771-16780 of 1611142 results.
ID: 16771
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 849385
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 16772
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 861848
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 16773
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 859835
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 16774
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 905273
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 16775
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099687
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 16776
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 312036
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 16777
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 856940
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2700
Qty Limit Days: 30
ID: 16778
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 834137
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 16779
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 810002
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 16780
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 809990
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30