CMS Formulary

Displaying 69271-69280 of 1611142 results.
ID: 69271
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 896245
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 69272
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 896273
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 69273
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 895996
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 69274
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 896001
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 69275
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 896006
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 24
Qty Limit Days: 28
ID: 69276
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1539893
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 69277
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1487528
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 69278
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1547660
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 69279
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1547672
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 69280
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1720606
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28