CMS Formulary

Displaying 65361-65370 of 1611142 results.
ID: 65361
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364118
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 65362
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364122
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 65363
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653243
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65364
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1599797
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65365
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1603361
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65366
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1603365
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65367
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1603369
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65368
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1656346
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65369
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1425110
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 65370
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1425118
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30