CMS Formulary

Displaying 65161-65170 of 1611142 results.
ID: 65161
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 861637
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65162
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 861206
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65163
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 904170
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65164
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 854859
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65165
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1859000
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 65166
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1604544
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 13
Qty Limit Days: 28
ID: 65167
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2002420
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 28
ID: 65168
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923338
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65169
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923347
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65170
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1876406
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0