CMS Formulary

Displaying 1071-1080 of 1611142 results.
ID: 1071
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1664328
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 1072
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1664325
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 1073
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1546083
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 1074
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1796091
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 1075
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1796096
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 1076
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1862688
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 1077
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1862701
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 1078
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1862697
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 1079
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1862692
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 1080
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1037181
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30