CMS Formulary

Displaying 67251-67260 of 1611142 results.
ID: 67251
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1115012
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 67252
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1115013
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 67253
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091632
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67254
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091629
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67255
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091635
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67256
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091638
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67257
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091623
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67258
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1543069
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 67259
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1010878
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67260
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1085741
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0