CMS Formulary

Displaying 65231-65240 of 1611142 results.
ID: 65231
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 197730
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65232
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 197731
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65233
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 311376
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 65234
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 864761
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1200
Qty Limit Days: 30
ID: 65235
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 864769
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 600
Qty Limit Days: 30
ID: 65236
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 315187
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65237
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 856724
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65238
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 856733
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65239
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 309371
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65240
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 197577
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0