CMS Formulary

Displaying 68401-68410 of 1611142 results.
ID: 68401
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 825130
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68402
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 260260
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68403
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1370758
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 68404
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 311382
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68405
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 861668
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 68406
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 830795
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68407
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 831359
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68408
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 801957
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68409
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 801961
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68410
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 801966
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0