CMS Formulary

Displaying 66231-66240 of 1611142 results.
ID: 66231
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 403811
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 66232
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806195
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 66233
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806179
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 66234
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806183
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 66235
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 308191
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66236
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 199119
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66237
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 864110
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66238
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 854302
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66239
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1793916
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 66240
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1657160
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28