CMS Formulary

Displaying 65851-65860 of 1611142 results.
ID: 65851
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 349477
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65852
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 198324
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65853
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 198325
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65854
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 198323
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65855
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 855942
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 65856
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 313366
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65857
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000070
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65858
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1536586
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 65859
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 242333
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 65860
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 241527
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28