CMS Formulary

Displaying 67041-67050 of 1611142 results.
ID: 67041
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2100099
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 180
ID: 67042
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2100100
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 180
ID: 67043
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 312614
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67044
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 283077
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67045
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 993755
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4500
Qty Limit Days: 30
ID: 67046
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 197448
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67047
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923432
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67048
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 578018
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67049
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 477391
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67050
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 197877
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30