CMS Formulary

Displaying 67081-67090 of 1611142 results.
ID: 67081
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1114202
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 67082
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1549683
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67083
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650968
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 84
ID: 67084
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650972
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 84
ID: 67085
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650974
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 84
ID: 67086
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650976
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 84
ID: 67087
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1739766
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 67088
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1739774
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 67089
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2173500
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 67090
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1739778
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30