CMS Formulary

Displaying 69511-69520 of 1611142 results.
ID: 69511
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 748806
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69512
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 748804
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69513
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 310404
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69514
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 310405
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69515
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 284191
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69516
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 359697
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69517
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 310169
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69518
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 861657
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69519
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 486148
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69520
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 486152
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0