CMS Formulary

Displaying 66721-66730 of 1611142 results.
ID: 66721
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 848730
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 66722
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 848734
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 66723
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 848752
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66724
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1491624
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 66725
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2468316
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 66726
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2381144
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66727
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 465355
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66728
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 979099
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66729
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 967023
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66730
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 967012
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0