CMS Formulary

Displaying 67021-67030 of 1611142 results.
ID: 67021
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2391560
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67022
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1657212
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67023
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1735537
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67024
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 992403
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67025
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1735496
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67026
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1147228
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 67027
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2197873
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 67028
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2197877
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 67029
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 205532
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67030
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1592285
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 270
Qty Limit Days: 30