CMS Formulary

Displaying 66581-66590 of 1611142 results.
ID: 66581
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 200193
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 30
ID: 66582
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 200194
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 30
ID: 66583
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 616539
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 66584
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 616541
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 66585
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 317094
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66586
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 349435
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66587
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 349434
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66588
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1013930
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66589
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 310289
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66590
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 855858
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30