CMS Formulary

Displaying 68011-68020 of 1611142 results.
ID: 68011
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 200031
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68012
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 200033
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68013
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 315223
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 30
ID: 68014
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 313161
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 30
ID: 68015
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 313160
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 9
Qty Limit Days: 30
ID: 68016
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 854873
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 68017
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 310796
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68018
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 310797
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68019
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 310809
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68020
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 198052
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0