CMS Formulary

Displaying 68241-68250 of 1611142 results.
ID: 68241
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1649990
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68242
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650030
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68243
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 198201
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68244
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 728109
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 84
Qty Limit Days: 180
ID: 68245
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 312122
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 42
Qty Limit Days: 180
ID: 68246
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 200346
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68247
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 308135
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68248
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 309054
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68249
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 848140
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68250
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 848131
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0