CMS Formulary

Displaying 67521-67530 of 1611142 results.
ID: 67521
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650901
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 67522
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2054995
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 7
Qty Limit Days: 7
ID: 67523
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123137
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 84
Qty Limit Days: 28
ID: 67524
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123141
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 67525
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123145
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 67526
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1102277
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67527
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 794610
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67528
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 831870
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67529
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 850457
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67530
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1236632
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0