CMS Formulary

Displaying 67151-67160 of 1611142 results.
ID: 67151
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 857366
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 170
Qty Limit Days: 30
ID: 67152
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 313226
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67153
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 308715
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 67154
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 848208
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67155
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 848176
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67156
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 848178
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67157
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 861505
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67158
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 313200
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67159
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 103456
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67160
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 310891
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0