CMS Formulary

Displaying 67371-67380 of 1611142 results.
ID: 67371
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1991509
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67372
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1865962
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67373
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 197699
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67374
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 197700
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67375
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 596926
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 67376
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 596930
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 67377
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 596934
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 67378
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 308192
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67379
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 834061
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67380
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 834102
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0