CMS Formulary

Displaying 65481-65490 of 1611142 results.
ID: 65481
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 309958
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65482
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 309960
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65483
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 884707
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 28
ID: 65484
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 753543
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65485
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2110455
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 65486
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 904870
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 65487
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 904876
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 65488
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1314763
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65489
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 309047
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65490
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 312594
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0