CMS Formulary

Displaying 69521-69530 of 1611142 results.
ID: 69521
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 486146
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69522
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 577057
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 69523
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 886634
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 5
Qty Limit Days: 28
ID: 69524
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1437702
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 540
Qty Limit Days: 30
ID: 69525
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 211343
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69526
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 857002
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 69527
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 857005
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 69528
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 856999
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 69529
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 2001565
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 69530
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 2001566
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30