CMS Formulary

Displaying 16961-16970 of 1611142 results.
ID: 16961
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1593775
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 16962
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 861045
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 28
ID: 16963
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 861043
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 28
ID: 16964
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 206347
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 16965
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 801357
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 16966
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 801112
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 16967
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 801136
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 16968
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1799706
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 16969
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 805131
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 16970
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 801648
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0