CMS Formulary

Displaying 70241-70250 of 1611142 results.
ID: 70241
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123194
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 70242
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 313565
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70243
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 313564
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70244
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 199885
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70245
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 242438
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70246
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 200094
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70247
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 200095
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70248
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 200096
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70249
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 197311
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70250
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 197313
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0