CMS Formulary

Displaying 65471-65480 of 1611142 results.
ID: 65471
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 757707
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 65472
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 403957
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 65473
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 636664
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65474
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 608328
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65475
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1148141
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 30
ID: 65476
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 861960
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 65477
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 905032
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 65478
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1090996
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65479
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 197595
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65480
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 197596
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0