CMS Formulary

Displaying 67711-67720 of 1611142 results.
ID: 67711
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1306298
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67712
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1551999
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 67713
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1484922
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 67714
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2203999
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 67715
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2204092
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 67716
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544471
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 67717
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544475
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 67718
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1591949
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 67719
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2204104
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 67720
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2204102
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28