CMS Formulary

Displaying 65061-65070 of 1611142 results.
ID: 65061
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1745114
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65062
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 729234
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65063
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 582971
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65064
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 582976
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65065
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1435117
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 65066
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 351859
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28
ID: 65067
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1731317
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 24
Qty Limit Days: 28
ID: 65068
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 643177
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 65069
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 643173
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 65070
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 643175
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30