CMS Formulary

Displaying 70341-70350 of 1611142 results.
ID: 70341
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 967023
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70342
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 967012
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70343
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 198332
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70344
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 856987
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 70345
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 856992
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 70346
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 197702
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70347
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049615
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 70348
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1736047
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 70349
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1736050
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 70350
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1736053
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30