CMS Formulary

Displaying 65091-65100 of 1611142 results.
ID: 65091
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1547575
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 65092
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1547110
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 65093
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243848
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 65094
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243843
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 65095
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243833
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 65096
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 665044
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 65097
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 665040
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 65098
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 744846
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65099
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 665036
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 65100
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1547114
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30