CMS Formulary

Displaying 68131-68140 of 1611142 results.
ID: 68131
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 200131
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68132
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 861237
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 68133
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 861221
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 68134
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 861223
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 68135
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 861225
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 68136
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 861227
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 68137
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 861232
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 68138
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1367436
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 68139
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 352210
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68140
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 198175
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0