CMS Formulary

Displaying 65341-65350 of 1611142 results.
ID: 65341
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 727705
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65342
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1655728
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65343
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 825170
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65344
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801278
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65345
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 847741
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 65346
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 835892
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65347
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2056897
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65348
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 746609
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 65349
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 845518
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 65350
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 845512
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28