CMS Formulary

Displaying 65301-65310 of 1611142 results.
ID: 65301
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047623
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 65302
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2463737
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 65303
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2463733
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 65304
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2105856
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 65305
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2168548
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 65306
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058932
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 65307
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1148506
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 65308
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1148502
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 65309
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2168540
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 65310
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 207088
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0