CMS Formulary

Displaying 65501-65510 of 1611142 results.
ID: 65501
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 643066
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65502
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1652084
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65503
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1006801
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 65504
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 996921
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 65505
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 721773
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 65506
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 476179
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 65507
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 476177
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 65508
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 199703
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65509
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1359129
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65510
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 485440
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30