CMS Formulary

Displaying 67141-67150 of 1611142 results.
ID: 67141
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 310364
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67142
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 238920
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67143
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 349351
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67144
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 204135
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67145
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1370754
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67146
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1370750
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67147
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 861487
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67148
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1992281
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67149
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 203088
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 67150
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 313227
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0