CMS Formulary

Displaying 66761-66770 of 1611142 results.
ID: 66761
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 312079
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 66762
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 208185
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66763
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 577127
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 66764
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 404013
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66765
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 404011
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66766
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 597990
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66767
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 597984
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66768
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 597993
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66769
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 597967
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66770
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 597980
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0