CMS Formulary

Displaying 67421-67430 of 1611142 results.
ID: 67421
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653166
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67422
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1100079
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 67423
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1918044
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 67424
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1928689
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67425
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2118741
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67426
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2000019
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 67427
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1994362
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 67428
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1442992
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 67429
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2000023
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 67430
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2000027
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28