CMS Formulary

Displaying 68631-68640 of 1611142 results.
ID: 68631
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 207373
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68632
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1245268
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 68633
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 314088
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68634
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 403914
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68635
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 885209
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68636
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1922765
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68637
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1922763
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68638
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 105553
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68639
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 105590
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68640
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364498
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 45
Qty Limit Days: 30