CMS Formulary

Displaying 69671-69680 of 1611142 results.
ID: 69671
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 197657
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69672
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 541878
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 69673
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 541892
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 69674
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 577961
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 69675
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 541363
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 69676
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 751868
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69677
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 751871
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69678
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 751870
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69679
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 762007
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69680
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 751885
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0