CMS Formulary

Displaying 68161-68170 of 1611142 results.
ID: 68161
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 637173
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68162
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 312840
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 68163
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 314209
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 68164
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 199206
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 68165
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 197805
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68166
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 197806
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68167
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 197807
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68168
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 311347
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68169
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 311204
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68170
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 898715
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 900
Qty Limit Days: 30