CMS Formulary

Displaying 65711-65720 of 1611142 results.
ID: 65711
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 197815
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65712
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1001004
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65713
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 351264
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 65714
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 904605
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65715
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 904571
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65716
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 904583
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65717
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 904593
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65718
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 848951
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65719
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 835958
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65720
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 834346
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0