CMS Formulary

Displaying 67111-67120 of 1611142 results.
ID: 67111
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 198036
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67112
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1193341
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 67113
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1193337
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 67114
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1193345
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 67115
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1193349
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 67116
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1193353
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 67117
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2359344
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 14
Qty Limit Days: 21
ID: 67118
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2359348
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 14
Qty Limit Days: 21
ID: 67119
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2359340
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 14
Qty Limit Days: 21
ID: 67120
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2361300
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30