CMS Formulary

Displaying 66671-66680 of 1611142 results.
ID: 66671
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1719286
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66672
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 313115
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66673
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 239240
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66674
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 310291
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66675
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 809871
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 20
Qty Limit Days: 30
ID: 66676
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 864661
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66677
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2001424
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66678
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1363408
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 66679
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1363410
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 66680
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364581
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28