CMS Formulary

Displaying 66411-66420 of 1611142 results.
ID: 66411
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 808753
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 66412
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 808744
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 66413
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 861601
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66414
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 861597
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66415
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 615882
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66416
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 284496
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66417
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 197848
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66418
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 855926
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 66419
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 855906
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 66420
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 855664
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30