CMS Formulary

Displaying 69031-69040 of 1611142 results.
ID: 69031
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 834022
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 20
Qty Limit Days: 30
ID: 69032
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 833217
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69033
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 831103
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69034
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 831102
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69035
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 831054
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69036
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 197724
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69037
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 197381
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69038
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 197379
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69039
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 197603
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69040
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 198107
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0