CMS Formulary

Displaying 65121-65130 of 1611142 results.
ID: 65121
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1292443
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65122
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 804186
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65123
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1292459
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 365
ID: 65124
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1658106
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65125
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1658102
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65126
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 798451
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65127
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 830263
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65128
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1658150
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65129
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2055815
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65130
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1441740
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0