CMS Formulary

Displaying 68281-68290 of 1611142 results.
ID: 68281
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 646456
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 68282
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1487251
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 68283
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 848768
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 68284
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1738511
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68285
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 205316
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68286
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 205315
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68287
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 313583
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 68288
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 313585
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 68289
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 992438
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68290
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 992447
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0