CMS Formulary

Displaying 65611-65620 of 1611142 results.
ID: 65611
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 242736
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65612
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 706546
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65613
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 311033
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28
ID: 65614
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 311027
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28
ID: 65615
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 213442
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28
ID: 65616
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1860172
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 15
Qty Limit Days: 28
ID: 65617
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2206092
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 65618
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2206099
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 65619
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049380
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 65620
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1986354
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28