CMS Formulary

Displaying 67101-67110 of 1611142 results.
ID: 67101
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1739788
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 600
Qty Limit Days: 30
ID: 67102
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1149617
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 67103
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 213197
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 67104
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 997010
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 42
Qty Limit Days: 7
ID: 67105
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 861353
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67106
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 866427
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67107
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 866412
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67108
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 866419
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67109
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 198034
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67110
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 198035
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0