CMS Formulary

Displaying 70921-70930 of 1611142 results.
ID: 70921
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 312077
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 70922
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 313412
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70923
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 313413
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70924
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 314286
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 70925
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 313776
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 70926
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 313777
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 70927
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 313778
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 70928
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 994005
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 70929
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 314214
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 70930
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 312835
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30