CMS Formulary

Displaying 65751-65760 of 1611142 results.
ID: 65751
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1986819
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 65752
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2289424
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 65753
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2289428
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 65754
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1942485
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 65755
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1942489
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 65756
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047639
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 65757
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2053927
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 65758
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1721571
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 65759
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1721583
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 65760
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1989109
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28