CMS Formulary

Displaying 68641-68650 of 1611142 results.
ID: 68641
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364490
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 68642
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364494
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 68643
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1648772
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 68644
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 884077
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68645
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2046597
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 228
Qty Limit Days: 14
ID: 68646
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 1989117
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 68647
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 2178792
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 68648
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 644304
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68649
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 861659
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68650
Formulary ID: 00021024
Formulary Version: 14
Contract Year: 2021
RXCUI: 861661
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0