CMS Formulary

Displaying 66101-66110 of 1611142 results.
ID: 66101
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 310149
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 4
ID: 66102
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000673
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66103
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 284254
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66104
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 197900
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 66105
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 197901
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 66106
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 197902
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 66107
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 311386
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66108
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 311385
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66109
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 314075
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66110
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 310812
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0