CMS Formulary

Displaying 69971-69980 of 1611142 results.
ID: 69971
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 311726
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69972
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 884386
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 69973
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 884385
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 69974
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 993770
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 69975
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 993890
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 69976
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 864718
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 69977
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 977939
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 69978
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 977942
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 69979
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 197593
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69980
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 199168
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0