CMS Formulary

Displaying 66401-66410 of 1611142 results.
ID: 66401
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 310288
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66402
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 197985
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66403
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 197984
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66404
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 598006
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66405
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 197650
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66406
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091155
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 66407
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091170
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 66408
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091185
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 66409
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091210
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 66410
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 808751
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30