CMS Formulary

Displaying 65261-65270 of 1611142 results.
ID: 65261
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243010
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 65262
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243014
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 65263
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1601394
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 65264
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1601386
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 65265
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1601390
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 65266
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1987734
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 65267
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058922
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 65268
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2103175
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 65269
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2103179
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 65270
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 810075
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0