CMS Formulary

Displaying 66121-66130 of 1611142 results.
ID: 66121
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 197502
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66122
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 863559
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66123
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1431286
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 66124
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 897612
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66125
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 897618
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66126
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 897624
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66127
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 897630
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66128
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 312025
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66129
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 198041
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66130
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 582926
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0