CMS Formulary

Displaying 65101-65110 of 1611142 results.
ID: 65101
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1547118
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 65102
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1235595
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65103
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1235591
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65104
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 668606
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65105
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 861821
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 65106
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 861771
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 65107
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1729311
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 65108
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2055766
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65109
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1734642
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 65110
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1988671
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28