CMS Formulary

Displaying 65901-65910 of 1611142 results.
ID: 65901
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 310404
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65902
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 310405
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65903
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 284191
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65904
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 359697
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65905
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 310169
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65906
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 861657
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65907
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 486148
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65908
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 486152
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65909
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 486146
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65910
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 577057
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30