CMS Formulary

Displaying 67321-67330 of 1611142 results.
ID: 67321
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 311277
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 67322
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099563
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67323
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 904932
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 67324
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 313758
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67325
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 199655
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67326
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 349208
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67327
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 360110
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67328
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 799055
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67329
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 799056
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67330
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 799054
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0