CMS Formulary

Displaying 65691-65700 of 1611142 results.
ID: 65691
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 197978
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65692
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1246306
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 65693
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1246290
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 65694
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1666334
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65695
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1116639
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65696
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1872261
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65697
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2055008
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65698
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 991233
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65699
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1098608
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65700
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 308047
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30