CMS Formulary

Displaying 16041-16050 of 1611142 results.
ID: 16041
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1602028
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 16042
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1602034
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 16043
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1602040
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 16044
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1602046
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 16045
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2265729
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 16046
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2265732
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 16047
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2265735
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 16048
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1809643
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 16049
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1809499
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 16050
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1495070
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 84
Qty Limit Days: 28