CMS Formulary

Displaying 65741-65750 of 1611142 results.
ID: 65741
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 801417
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65742
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 204520
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65743
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1799890
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65744
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 800928
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65745
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 800812
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65746
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1189640
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65747
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 800933
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65748
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2001321
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 65749
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091843
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 65750
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 402091
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30