CMS Formulary

Displaying 68351-68360 of 1611142 results.
ID: 68351
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 311264
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68352
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 897649
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68353
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 349594
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 68354
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 349595
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 68355
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 608143
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 68356
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 608139
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 68357
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 897659
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68358
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 897640
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68359
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 855480
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68360
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 855474
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0