CMS Formulary

Displaying 66821-66830 of 1611142 results.
ID: 66821
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 238600
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66822
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 141859
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 5
Qty Limit Days: 4
ID: 66823
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 310465
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 66824
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1085640
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66825
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1244634
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66826
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1085633
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66827
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1085636
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66828
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 197735
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 66829
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 543546
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 66830
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1085644
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0