CMS Formulary

Displaying 69471-69480 of 1611142 results.
ID: 69471
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 242333
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 69472
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 241527
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 69473
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 403922
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 69474
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 402109
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69475
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 834235
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 69476
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 834241
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 69477
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 359144
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69478
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 359145
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69479
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000076
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69480
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1298088
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30