CMS Formulary

Displaying 69851-69860 of 1611142 results.
ID: 69851
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1793916
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 69852
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1657160
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 69853
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1654630
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 69854
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 2000007
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 69855
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 309339
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69856
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 309335
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69857
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 309336
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69858
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 308207
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69859
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1721475
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69860
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 789980
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0