CMS Formulary

Displaying 70841-70850 of 1611142 results.
ID: 70841
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091341
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 900
Qty Limit Days: 30
ID: 70842
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1359124
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70843
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 403884
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70844
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 310599
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70845
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 856535
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70846
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 856569
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70847
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 856460
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70848
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 856481
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70849
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 860654
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70850
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 866144
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0