CMS Formulary

Displaying 68031-68040 of 1611142 results.
ID: 68031
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 854984
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68032
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 854988
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68033
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 854925
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68034
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 857166
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68035
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 857174
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68036
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 904431
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 68037
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 312087
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68038
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 198334
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68039
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 198335
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68040
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 433798
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30