CMS Formulary

Displaying 66961-66970 of 1611142 results.
ID: 66961
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 896758
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66962
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 896762
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66963
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 199369
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66964
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 861164
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66965
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 861171
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66966
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 645037
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 66967
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000064
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66968
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 197987
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66969
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 197986
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 66970
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 860215
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0