CMS Formulary

Displaying 69101-69110 of 1611142 results.
ID: 69101
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 309047
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69102
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 312594
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69103
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 198141
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69104
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 834046
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69105
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 834040
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69106
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 197536
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 69107
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 429212
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 69108
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 309374
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 135
Qty Limit Days: 30
ID: 69109
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1299917
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69110
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 995218
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0