CMS Formulary

Displaying 65551-65560 of 1611142 results.
ID: 65551
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 828379
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65552
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1860154
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 65553
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1860151
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 65554
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1860127
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 65555
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 856448
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65556
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 856457
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65557
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 856519
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65558
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 856578
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65559
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 856556
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65560
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 242831
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0