CMS Formulary

Displaying 66711-66720 of 1611142 results.
ID: 66711
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 891881
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 66712
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 891888
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 66713
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 891893
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 66714
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 891874
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 66715
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 892646
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 66716
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 848726
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 66717
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 848738
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 66718
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 848742
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 66719
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 848746
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 66720
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 848750
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30