CMS Formulary

Displaying 16831-16840 of 1611142 results.
ID: 16831
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 2200658
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 16832
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 2200650
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 16833
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653204
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 16834
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 351926
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28
ID: 16835
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 849851
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 16836
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 847247
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 16837
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 847348
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 16838
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 847245
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 16839
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 197590
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 16840
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 197591
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30