CMS Formulary

Displaying 65071-65080 of 1611142 results.
ID: 65071
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 799830
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 65072
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1045408
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 65073
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1045404
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 65074
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364441
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 65075
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364447
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 65076
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1145932
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65077
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1799230
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65078
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1925255
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65079
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1925257
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65080
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1598989
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0