CMS Formulary

Displaying 69411-69420 of 1611142 results.
ID: 69411
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 197438
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69412
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 197439
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69413
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1298861
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69414
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1298870
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69415
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 856769
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69416
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 314034
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69417
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 198284
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69418
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 197316
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69419
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 310671
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69420
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 856792
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0