CMS Formulary

Displaying 65111-65120 of 1611142 results.
ID: 65111
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1988675
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 65112
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1924315
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65113
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1486841
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65114
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 798300
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65115
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 830253
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65116
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 830245
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65117
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 836636
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65118
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 836634
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65119
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1597099
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 365
ID: 65120
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1597103
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 365