CMS Formulary

Displaying 65651-65660 of 1611142 results.
ID: 65651
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 896027
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 65652
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 896023
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 65653
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 213484
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65654
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 759473
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 180
ID: 65655
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 896185
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 65656
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 896212
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 65657
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 896229
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 65658
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 896237
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 65659
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 896245
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 65660
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 896273
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30