CMS Formulary

Displaying 67751-67760 of 1611142 results.
ID: 67751
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 897590
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67752
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 897596
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67753
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 317769
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67754
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 314208
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67755
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 312847
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67756
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 205284
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67757
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 205285
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67758
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 643019
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 67759
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 643022
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 67760
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 866482
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0