CMS Formulary

Displaying 66801-66810 of 1611142 results.
ID: 66801
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 582984
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66802
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2122661
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66803
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2122659
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66804
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2122657
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66805
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2122655
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66806
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2122650
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66807
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2122648
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66808
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2122642
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66809
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2477272
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 66810
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 795749
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0