CMS Formulary

Displaying 16011-16020 of 1611142 results.
ID: 16011
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1251336
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 16012
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 749157
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 16013
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 748798
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 16014
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1989507
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 16015
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1876920
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 16016
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1876924
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 16017
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1876916
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 16018
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1111642
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 16019
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1487363
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 16020
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 308725
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 420
Qty Limit Days: 30