CMS Formulary

Displaying 65771-65780 of 1611142 results.
ID: 65771
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 861043
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 28
ID: 65772
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 206347
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65773
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 801357
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65774
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 801112
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65775
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 801136
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65776
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1799706
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65777
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 805131
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65778
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 801648
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65779
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 800420
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65780
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 800405
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0