CMS Formulary

Displaying 67911-67920 of 1611142 results.
ID: 67911
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 617768
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 67912
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790892
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 67913
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790886
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 67914
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790890
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 67915
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2384465
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 5
Qty Limit Days: 28
ID: 67916
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1670324
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 80
Qty Limit Days: 28
ID: 67917
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1670322
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 28
ID: 67918
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 977923
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 67919
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 977929
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 67920
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 977874
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30