CMS Formulary

Displaying 68041-68050 of 1611142 results.
ID: 68041
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 433800
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 68042
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 433799
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 68043
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 433801
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 68044
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 979468
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68045
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 979464
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68046
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 979471
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68047
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 198188
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68048
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 313134
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68049
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 562508
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68050
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 617430
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0