CMS Formulary

Displaying 69541-69550 of 1611142 results.
ID: 69541
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806197
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 69542
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 897696
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 69543
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 897702
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 69544
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 897710
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 69545
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 864706
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 69546
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049611
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 69547
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049618
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 69548
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 884535
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 69549
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 884532
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 69550
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 245136
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30