CMS Formulary

Displaying 65221-65230 of 1611142 results.
ID: 65221
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 977427
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65222
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 977434
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65223
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 977438
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65224
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 892625
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 65225
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 311355
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65226
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 197893
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65227
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 313932
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65228
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 309843
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1200
Qty Limit Days: 30
ID: 65229
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1190568
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65230
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1797907
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 30