CMS Formulary

Displaying 67501-67510 of 1611142 results.
ID: 67501
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 404450
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 67502
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1242233
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 67503
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 616116
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 67504
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 616114
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 67505
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 643714
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 67506
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1429367
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 67507
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 643722
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 67508
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1369724
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 67509
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1369728
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 67510
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1369732
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28