CMS Formulary

Displaying 68581-68590 of 1611142 results.
ID: 68581
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 206883
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68582
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2473107
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68583
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 206902
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68584
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 483450
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 68585
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 483438
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 68586
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 483440
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 68587
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 483444
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 68588
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2178403
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 68589
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2178405
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 28
ID: 68590
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2382990
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 24
Qty Limit Days: 28