CMS Formulary

Displaying 67281-67290 of 1611142 results.
ID: 67281
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 198224
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67282
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 318179
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67283
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 283535
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67284
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 858778
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 67285
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 198222
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67286
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 198150
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67287
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 96304
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67288
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 998689
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67289
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 998685
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67290
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2099686
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28