CMS Formulary

Displaying 66831-66840 of 1611142 results.
ID: 66831
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1014314
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66832
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1085686
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66833
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1797895
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 66834
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 151030
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66835
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 977990
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66836
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 977978
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66837
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 309289
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 66838
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 309291
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 19
Qty Limit Days: 30
ID: 66839
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 895487
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66840
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 895987
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0