CMS Formulary

Displaying 16821-16830 of 1611142 results.
ID: 16821
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1986356
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 16822
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 2205454
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 16823
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653198
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 16824
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 977842
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28
ID: 16825
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 977840
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 16826
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 897126
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 9
Qty Limit Days: 30
ID: 16827
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 2398842
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 16828
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1991311
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 16829
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1991317
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 16830
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 2200654
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30