CMS Formulary

Displaying 65721-65730 of 1611142 results.
ID: 65721
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 993466
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65722
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 993470
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65723
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 993462
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65724
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047868
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 65725
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 834350
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65726
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801299
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65727
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 832731
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65728
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801295
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65729
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123111
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 13
Qty Limit Days: 30
ID: 65730
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 198071
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0