CMS Formulary

Displaying 65921-65930 of 1611142 results.
ID: 65921
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049221
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 65922
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049225
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 65923
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049214
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 65924
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091497
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 65925
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091392
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 65926
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091145
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 65927
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091225
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 65928
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806181
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 65929
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806197
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 65930
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 897696
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30