CMS Formulary

Displaying 69681-69690 of 1611142 results.
ID: 69681
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 753481
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69682
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 762333
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69683
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 751890
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69684
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1358780
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69685
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1358765
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69686
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1359030
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69687
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1359025
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69688
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1359135
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69689
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1095362
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69690
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 753482
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0