CMS Formulary

Displaying 70811-70820 of 1611142 results.
ID: 70811
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 748879
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70812
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 238153
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 70813
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 359385
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70814
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 834768
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70815
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 835956
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70816
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 748859
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70817
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 751875
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70818
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 903456
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70819
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 903697
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70820
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 903703
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0