CMS Formulary

Displaying 65811-65820 of 1611142 results.
ID: 65811
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 856706
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65812
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 856429
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65813
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 310670
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65814
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1373483
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 14
Qty Limit Days: 7
ID: 65815
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1373491
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 65816
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 856797
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65817
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 866491
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65818
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 197963
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65819
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 197508
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65820
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 197318
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0