CMS Formulary

Displaying 68381-68390 of 1611142 results.
ID: 68381
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 314266
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 30
ID: 68382
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 749784
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68383
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 644088
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 68384
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1603861
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 84
ID: 68385
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1251336
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68386
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 749157
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68387
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 748798
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68388
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1989507
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68389
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1053697
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68390
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 197849
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0