CMS Formulary

Displaying 67401-67410 of 1611142 results.
ID: 67401
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 198105
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67402
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 198104
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67403
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1662285
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67404
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 205329
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 67405
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 205330
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 67406
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 205331
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 67407
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 999967
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67408
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 999996
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67409
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 999986
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67410
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000001
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0