CMS Formulary

Displaying 68171-68180 of 1611142 results.
ID: 68171
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 282755
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68172
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 205304
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68173
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 205305
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68174
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 409823
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68175
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 892582
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 68176
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 892672
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 68177
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923822
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68178
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923828
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68179
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923826
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68180
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1490026
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30