CMS Formulary

Displaying 65131-65140 of 1611142 results.
ID: 65131
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 835721
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65132
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1046920
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1008
Qty Limit Days: 90
ID: 65133
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 404457
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65134
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 404458
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65135
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 404459
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65136
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1549456
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65137
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1549454
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65138
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 205562
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65139
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 763489
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65140
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 996559
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0