CMS Formulary

Displaying 66461-66470 of 1611142 results.
ID: 66461
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 895670
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 66462
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 197319
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66463
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 197320
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66464
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 197527
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 66465
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 197528
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 66466
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 197529
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 66467
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 312744
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 66468
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 616487
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 66469
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 312962
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 66470
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 349332
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0