CMS Formulary

Displaying 67781-67790 of 1611142 results.
ID: 67781
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 104884
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67782
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 861430
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67783
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 197939
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67784
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 197940
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67785
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 886662
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67786
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 886666
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67787
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 886671
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67788
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 686400
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67789
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1190572
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67790
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 686418
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0