CMS Formulary

Displaying 16861-16870 of 1611142 results.
ID: 16861
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 895996
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 16862
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 896001
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 16863
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 896006
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 24
Qty Limit Days: 28
ID: 16864
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1539893
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 16865
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1487528
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 16866
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1547660
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 16867
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1547672
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 16868
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1720606
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 16869
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1648789
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 16870
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1945048
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30