CMS Formulary

Displaying 68421-68430 of 1611142 results.
ID: 68421
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1602028
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 68422
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1602034
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 68423
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1602040
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 68424
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1602046
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 68425
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2265729
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 68426
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2265732
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 68427
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2265735
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 68428
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1809643
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68429
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1809499
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68430
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1495070
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 84
Qty Limit Days: 28