CMS Formulary

Displaying 66931-66940 of 1611142 results.
ID: 66931
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 727316
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 66932
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1870207
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 66933
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1374574
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 224
Qty Limit Days: 28
ID: 66934
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2003255
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66935
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2198370
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 66936
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 865208
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 66937
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 865212
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 66938
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 865216
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 66939
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 723827
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66940
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 729201
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0