CMS Formulary

Displaying 68911-68920 of 1611142 results.
ID: 68911
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047614
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 68912
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047596
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 68913
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047623
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 68914
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 2463737
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 68915
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 2463733
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 68916
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 2105856
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 68917
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 2168548
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 68918
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058932
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 68919
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1148506
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 68920
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1148502
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30