CMS Formulary

Displaying 70741-70750 of 1611142 results.
ID: 70741
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1999389
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 70742
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1812470
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 70743
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1655934
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 70744
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 2053512
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 70745
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 904447
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 28
ID: 70746
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 904158
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70747
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 861495
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70748
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 861448
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70749
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 309370
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70750
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 315059
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30