CMS Formulary

Displaying 67641-67650 of 1611142 results.
ID: 67641
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 205328
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67642
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 314155
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 67643
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 351107
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 67644
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 859193
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67645
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 686379
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 67646
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 855818
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 67647
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 855812
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 67648
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665050
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67649
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665093
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67650
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665088
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0