CMS Formulary

Displaying 65491-65500 of 1611142 results.
ID: 65491
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 198141
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65492
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 834046
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65493
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 834040
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65494
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 197536
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 65495
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 429212
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 65496
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 309374
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 135
Qty Limit Days: 30
ID: 65497
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1299917
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65498
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 995218
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65499
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1299896
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65500
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 866090
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0