CMS Formulary

Displaying 66241-66250 of 1611142 results.
ID: 66241
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1654630
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 66242
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2000007
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 66243
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 309339
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66244
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 309335
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66245
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 309336
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66246
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 308207
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66247
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1721475
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66248
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 789980
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66249
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 828755
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66250
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 828539
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0