CMS Formulary

Displaying 66791-66800 of 1611142 results.
ID: 66791
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 751568
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66792
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 751570
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66793
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 897044
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66794
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 758032
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 66795
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 758027
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 66796
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650282
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66797
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 207836
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66798
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 796918
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66799
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1649996
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 66800
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650004
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28