CMS Formulary

Displaying 65041-65050 of 1611142 results.
ID: 65041
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1551300
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 65042
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1551306
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 65043
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058877
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 30
ID: 65044
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1745108
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65045
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2395779
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 65046
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058887
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 30
ID: 65047
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2370174
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 65048
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2170613
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 30
ID: 65049
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2395785
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 65050
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2370170
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30