CMS Formulary

Displaying 65151-65160 of 1611142 results.
ID: 65151
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1009341
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 25
ID: 65152
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1595462
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65153
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1595473
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65154
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1595478
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65155
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1595292
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65156
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1995479
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65157
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1595457
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65158
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2268231
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 30
ID: 65159
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2268227
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 30
ID: 65160
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 402092
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30