CMS Formulary

Displaying 69701-69710 of 1611142 results.
ID: 69701
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 312529
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69702
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 977880
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69703
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047882
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69704
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 310190
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69705
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 310191
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69706
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 261178
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 69707
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 313941
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 69708
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 198300
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69709
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 106303
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69710
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 313450
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0