CMS Formulary

Displaying 66781-66790 of 1611142 results.
ID: 66781
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 103968
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66782
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 252479
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66783
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1010600
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 66784
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1307056
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 66785
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1010604
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 66786
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 198182
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66787
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 351223
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 66788
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 198070
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66789
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 401938
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 66790
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 751566
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0