CMS Formulary

Displaying 68481-68490 of 1611142 results.
ID: 68481
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1798375
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 68482
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 200132
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 68483
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 199149
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 68484
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 199150
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 68485
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 311915
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68486
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1725064
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 68487
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2001439
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 68488
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1437713
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68489
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1918242
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 68490
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1862595
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30