CMS Formulary

Displaying 70421-70430 of 1611142 results.
ID: 70421
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 2477272
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 70422
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 795749
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70423
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1809520
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70424
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 239189
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70425
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665107
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70426
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 309072
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70427
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 863538
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70428
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665507
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70429
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1191299
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70430
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 240209
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0