CMS Formulary

Displaying 68191-68200 of 1611142 results.
ID: 68191
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 311288
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68192
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 311289
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68193
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 387003
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68194
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 807832
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68195
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 846378
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68196
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 309112
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68197
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 309114
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68198
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 828373
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68199
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 310274
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68200
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 313570
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 30