CMS Formulary

Displaying 66381-66390 of 1611142 results.
ID: 66381
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 402698
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66382
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 402696
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66383
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 402695
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66384
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 351249
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66385
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 858625
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66386
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 855182
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66387
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 855189
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66388
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 602964
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 66389
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 402131
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 66390
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 349545
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30