CMS Formulary

Displaying 65761-65770 of 1611142 results.
ID: 65761
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2205634
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 65762
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2387331
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 28
ID: 65763
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1486981
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 65764
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1486977
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 65765
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1940498
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 65766
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1593831
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 65767
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1593833
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 65768
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1593835
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 65769
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1593775
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 65770
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 861045
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 28