CMS Formulary

Displaying 65631-65640 of 1611142 results.
ID: 65631
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2200658
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 65632
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2200650
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 65633
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653204
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 65634
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 351926
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28
ID: 65635
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 849851
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65636
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 847247
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65637
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 847348
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65638
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 847245
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65639
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 197590
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 65640
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 197591
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30