CMS Formulary

Displaying 66901-66910 of 1611142 results.
ID: 66901
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 311994
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 66902
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 311995
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 66903
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1648759
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 66904
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 903847
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66905
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1307061
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 66906
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1115698
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 540
Qty Limit Days: 180
ID: 66907
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1308569
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 66908
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 351209
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66909
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 310362
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66910
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 197623
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0