CMS Formulary

Displaying 66301-66310 of 1611142 results.
ID: 66301
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1809667
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66302
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 854228
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 30
ID: 66303
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 854235
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 24
Qty Limit Days: 30
ID: 66304
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 854238
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 36
Qty Limit Days: 30
ID: 66305
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 854241
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 48
Qty Limit Days: 30
ID: 66306
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 854248
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 66307
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 854245
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 48
Qty Limit Days: 30
ID: 66308
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 854252
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 66309
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 406503
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66310
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 858262
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0