CMS Formulary

Displaying 69561-69570 of 1611142 results.
ID: 69561
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 831430
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69562
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1807516
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69563
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665210
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69564
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 239209
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69565
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1807518
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69566
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1860139
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69567
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 800192
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69568
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665021
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69569
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 309090
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69570
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 309092
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0