CMS Formulary

Displaying 67981-67990 of 1611142 results.
ID: 67981
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1873765
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 67982
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801519
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 67983
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 539789
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 9
Qty Limit Days: 30
ID: 67984
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 856666
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 67985
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 979115
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 28
ID: 67986
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1244062
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 28
ID: 67987
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1244064
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 11
Qty Limit Days: 28
ID: 67988
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1596778
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 67989
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1673274
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 67990
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1673278
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28