CMS Formulary

Displaying 68811-68820 of 1611142 results.
ID: 68811
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 351265
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 68812
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 351266
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 68813
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 351267
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 68814
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 905172
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68815
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 905168
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68816
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 892589
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 700
Qty Limit Days: 30
ID: 68817
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 894780
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 68818
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 997287
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 68819
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 997296
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 68820
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 310792
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0