CMS Formulary

Displaying 66361-66370 of 1611142 results.
ID: 66361
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 884385
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 66362
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 993770
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 66363
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 993890
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 66364
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 864718
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 66365
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 977939
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 66366
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 977942
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 66367
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 197593
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66368
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 199168
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66369
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 312357
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66370
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 312362
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0