CMS Formulary

Displaying 65911-65920 of 1611142 results.
ID: 65911
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 886634
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 5
Qty Limit Days: 28
ID: 65912
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1437702
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 540
Qty Limit Days: 30
ID: 65913
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 211343
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65914
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 857002
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 65915
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 857005
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 65916
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 856999
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 65917
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2001565
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 65918
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2001566
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 65919
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2001568
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 65920
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 993781
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30