CMS Formulary

Displaying 67811-67820 of 1611142 results.
ID: 67811
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1356572
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 67812
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1356576
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 67813
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1356580
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 67814
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1356584
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 67815
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1356588
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 67816
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790126
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 720
Qty Limit Days: 30
ID: 67817
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 824299
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67818
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 824303
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67819
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2054157
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67820
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1796665
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0