CMS Formulary

Displaying 67131-67140 of 1611142 results.
ID: 67131
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1655934
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 67132
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2053512
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 67133
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 904447
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 28
ID: 67134
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 904158
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67135
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 861495
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67136
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 861448
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67137
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 309370
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67138
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 315059
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 67139
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 103457
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67140
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 197407
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0