CMS Formulary

Displaying 68361-68370 of 1611142 results.
ID: 68361
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 749860
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68362
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 198373
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 68363
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1094543
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68364
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 859033
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68365
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 859040
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68366
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 859052
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68367
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 855642
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 28
ID: 68368
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 312504
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68369
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 313291
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68370
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1245919
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0