CMS Formulary

Displaying 66171-66180 of 1611142 results.
ID: 66171
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243040
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 66172
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243026
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 66173
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1545664
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 66174
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1545668
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 66175
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1651275
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 66176
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1664321
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 66177
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1667882
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 66178
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665369
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 66179
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1664328
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 66180
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1664325
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30