CMS Formulary

Displaying 69751-69760 of 1611142 results.
ID: 69751
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 311893
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69752
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 199521
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 69753
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 198076
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69754
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 198077
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69755
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 198078
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69756
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 198075
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69757
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 313472
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 69758
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 198153
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69759
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 905269
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69760
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 905283
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0