CMS Formulary

Displaying 69551-69560 of 1611142 results.
ID: 69551
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 245134
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 69552
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 245135
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 69553
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 197696
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 69554
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1870650
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69555
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 829762
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69556
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1191234
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69557
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1724338
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69558
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1658637
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69559
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 307718
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69560
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 307719
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0