CMS Formulary

Displaying 67171-67180 of 1611142 results.
ID: 67171
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 858828
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67172
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 308976
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67173
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 834348
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67174
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1370767
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 67175
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 310379
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67176
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 310380
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67177
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1313112
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67178
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1370770
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 67179
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 855671
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67180
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 311679
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0