CMS Formulary

Displaying 65961-65970 of 1611142 results.
ID: 65961
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 727575
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65962
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1040012
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65963
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1040016
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65964
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653470
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65965
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1086776
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 65966
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1086780
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 65967
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1086786
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 65968
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1307415
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 65969
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1307421
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 65970
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1869699
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30