CMS Formulary

Displaying 67461-67470 of 1611142 results.
ID: 67461
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 903841
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67462
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1114470
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 67463
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049504
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 67464
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049545
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 67465
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049565
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 67466
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049576
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 67467
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049586
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 67468
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049595
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 67469
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049601
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 67470
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544404
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0