CMS Formulary

Displaying 69781-69790 of 1611142 results.
ID: 69781
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1592752
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 69782
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243033
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 69783
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243040
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 69784
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243026
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 69785
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1545664
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 69786
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1545668
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 69787
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1651275
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 69788
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1664321
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 69789
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1667882
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 69790
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665369
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30