CMS Formulary

Displaying 67121-67130 of 1611142 results.
ID: 67121
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2361296
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 67122
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2174390
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 67123
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243052
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 67124
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1606866
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 67125
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2257013
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 84
Qty Limit Days: 28
ID: 67126
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1606870
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 67127
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2053519
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 67128
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2166401
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 67129
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1999389
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 67130
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1812470
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30