CMS Formulary

Displaying 66861-66870 of 1611142 results.
ID: 66861
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1053753
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66862
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1006688
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66863
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 861434
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66864
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 197785
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66865
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 197803
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66866
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 861490
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66867
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 798133
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66868
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 884520
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 66869
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 755470
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66870
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 544452
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0