CMS Formulary

Displaying 70081-70090 of 1611142 results.
ID: 70081
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 312962
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 70082
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 349332
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70083
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 351250
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70084
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 856834
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70085
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 856845
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70086
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 856853
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70087
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 856762
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70088
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 856773
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70089
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 429503
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70090
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 310798
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0