CMS Formulary

Displaying 67921-67930 of 1611142 results.
ID: 67921
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 977894
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 67922
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 977902
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 67923
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 977909
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 67924
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 977915
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 67925
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 309952
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67926
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 197622
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67927
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 309955
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67928
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1117531
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 50
Qty Limit Days: 30
ID: 67929
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1116758
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 25
Qty Limit Days: 30
ID: 67930
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 543492
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0