CMS Formulary

Displaying 70771-70780 of 1611142 results.
ID: 70771
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 103456
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70772
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 310891
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70773
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 308979
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70774
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 197686
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70775
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 197303
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70776
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 197304
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70777
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 197853
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70778
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 858813
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70779
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 858817
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70780
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 858810
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0