CMS Formulary

Displaying 66021-66030 of 1611142 results.
ID: 66021
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 865123
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66022
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 860918
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66023
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 859841
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66024
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 313159
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 30
ID: 66025
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 197516
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66026
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 197517
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66027
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 996740
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 66028
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 311369
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 480
Qty Limit Days: 30
ID: 66029
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1482908
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66030
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806187
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30