CMS Formulary

Displaying 66661-66670 of 1611142 results.
ID: 66661
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 905092
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 66662
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 905100
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 66663
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 153822
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66664
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 153823
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66665
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 639537
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66666
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 578325
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66667
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 578330
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66668
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 802749
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66669
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1095712
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66670
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665515
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0