CMS Formulary

Displaying 67901-67910 of 1611142 results.
ID: 67901
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 866111
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67902
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 198252
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67903
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1649593
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 67904
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1546189
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 67905
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2261794
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 67906
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1040058
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 67907
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 858804
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67908
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 794641
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 67909
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 902624
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 67910
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 902626
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30