CMS Formulary

Displaying 66641-66650 of 1611142 results.
ID: 66641
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 485436
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66642
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 859424
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 66643
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 859747
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 66644
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 859751
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 66645
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 859419
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 66646
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 199192
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66647
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 199193
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66648
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 198382
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66649
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 997226
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 66650
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 997220
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30