CMS Formulary

Displaying 65401-65410 of 1611142 results.
ID: 65401
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2121100
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 65402
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2390954
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 65403
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 545293
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65404
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 207029
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65405
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 665022
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65406
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1720881
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65407
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1251596
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65408
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 207035
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65409
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 261101
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65410
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 847232
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28