CMS Formulary

Displaying 67481-67490 of 1611142 results.
ID: 67481
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1658325
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 67482
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1658329
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 67483
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1658333
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 67484
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1658337
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 67485
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1658341
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 67486
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1658345
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 67487
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1602604
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 67488
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1602607
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 67489
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2274816
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 67490
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2274814
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28