CMS Formulary

Displaying 69631-69640 of 1611142 results.
ID: 69631
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 309844
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1200
Qty Limit Days: 30
ID: 69632
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 865117
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69633
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 865123
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69634
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 860918
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69635
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 859841
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69636
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 313159
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 30
ID: 69637
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 197516
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69638
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 197517
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69639
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 996740
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 69640
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 311369
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 480
Qty Limit Days: 30