CMS Formulary

Displaying 66271-66280 of 1611142 results.
ID: 66271
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 244374
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66272
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 238004
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 66273
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 313921
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 66274
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 238003
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 66275
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 403923
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 66276
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 241946
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 66277
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 198322
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66278
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 308962
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66279
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 849395
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66280
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 991039
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0