CMS Formulary

Displaying 70371-70380 of 1611142 results.
ID: 70371
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 312750
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70372
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 312748
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70373
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 312079
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 70374
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 208185
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70375
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 577127
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 70376
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 404013
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70377
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 404011
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70378
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 597990
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70379
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 597984
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70380
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 597993
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0