CMS Formulary

Displaying 65831-65840 of 1611142 results.
ID: 65831
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 998675
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 65832
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 998679
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 65833
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000048
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65834
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 876524
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65835
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 876514
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65836
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 876529
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65837
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 876519
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65838
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 312593
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65839
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 966220
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65840
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 966221
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0