CMS Formulary

Displaying 65191-65200 of 1611142 results.
ID: 65191
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000500
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65192
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000487
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65193
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653579
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65194
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 198148
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65195
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1797833
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 65196
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1797844
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 15
Qty Limit Days: 10
ID: 65197
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 885857
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65198
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 860901
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 200
Qty Limit Days: 30
ID: 65199
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 351265
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 65200
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 351266
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30