CMS Formulary

Displaying 67411-67420 of 1611142 results.
ID: 67411
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 999991
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67412
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 984082
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67413
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1551923
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 67414
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1601373
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 67415
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1654079
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67416
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 853354
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67417
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 853356
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67418
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 848164
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67419
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653144
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67420
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1482814
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0