CMS Formulary

Displaying 68791-68800 of 1611142 results.
ID: 68791
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 863829
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68792
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1373327
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68793
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 905164
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68794
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 688242
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68795
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 208513
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68796
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 404550
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68797
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 150840
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68798
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 208949
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68799
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 202301
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68800
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000491
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0