CMS Formulary

Displaying 67871-67880 of 1611142 results.
ID: 67871
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1807632
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67872
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1795609
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67873
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1795477
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67874
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 581531
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67875
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2371050
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 67876
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2371054
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 67877
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2371058
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 67878
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2371062
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 67879
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2371066
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 67880
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1482513
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30