CMS Formulary

Displaying 65251-65260 of 1611142 results.
ID: 65251
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 105585
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65252
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 197931
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65253
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 312617
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65254
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 198144
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65255
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 198146
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65256
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 213272
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65257
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 207100
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65258
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 804547
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65259
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1307630
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 65260
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1307635
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30