CMS Formulary

Displaying 68861-68870 of 1611142 results.
ID: 68861
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 197861
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68862
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 197862
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68863
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 105585
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68864
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 197931
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68865
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 312617
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68866
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 198144
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68867
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 198146
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68868
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 213272
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68869
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 207100
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 68870
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 804547
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0