CMS Formulary

Displaying 67581-67590 of 1611142 results.
ID: 67581
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 198318
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 67582
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000126
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 84
ID: 67583
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000153
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 84
ID: 67584
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 198232
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67585
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 311727
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67586
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 317128
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67587
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 309337
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67588
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 197388
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67589
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 197980
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67590
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 544455
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0