CMS Formulary

Displaying 67661-67670 of 1611142 results.
ID: 67661
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 731568
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67662
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 731571
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67663
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 476872
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67664
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049223
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 67665
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049227
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 67666
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049216
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 67667
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 854801
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67668
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 313477
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67669
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 861200
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67670
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 861208
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0