CMS Formulary

Displaying 68201-68210 of 1611142 results.
ID: 68201
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 313571
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 80
Qty Limit Days: 30
ID: 68202
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 309049
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68203
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 309048
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68204
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 105171
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68205
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 995599
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68206
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 995607
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68207
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 307650
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68208
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 616402
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 68209
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 309097
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68210
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 309098
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0