CMS Formulary

Displaying 67331-67340 of 1611142 results.
ID: 67331
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 206913
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67332
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 206917
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67333
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1657151
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 67334
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 994008
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 67335
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 900156
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67336
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 848582
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67337
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 824959
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67338
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 749206
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67339
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659592
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67340
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659598
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0