CMS Formulary

Displaying 66851-66860 of 1611142 results.
ID: 66851
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 358917
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66852
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 309333
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 66853
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1992273
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66854
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 477451
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 30
ID: 66855
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 855168
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66856
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 198245
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66857
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1540241
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66858
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1597076
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 66859
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 992441
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66860
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 992454
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0