CMS Formulary

Displaying 69621-69630 of 1611142 results.
ID: 69621
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000913
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69622
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 198202
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69623
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 857677
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69624
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1245443
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69625
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1245373
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69626
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 309329
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69627
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 314078
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69628
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 197635
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 69629
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 197634
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 69630
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 238154
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30