CMS Formulary

Displaying 65211-65220 of 1611142 results.
ID: 65211
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 477234
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65212
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 199519
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65213
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 197624
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65214
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1437968
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65215
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1437969
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65216
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 897657
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1200
Qty Limit Days: 30
ID: 65217
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049604
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1300
Qty Limit Days: 30
ID: 65218
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1874559
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 65219
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1874553
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 65220
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 900575
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0