CMS Formulary

Displaying 69481-69490 of 1611142 results.
ID: 69481
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1298091
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 69482
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 242892
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 69483
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1149632
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 69484
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 242891
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 69485
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 248478
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 69486
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 198296
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69487
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000097
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69488
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 830865
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69489
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 830869
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69490
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 830872
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0