CMS Formulary

Displaying 70961-70970 of 1611142 results.
ID: 70961
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 861360
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70962
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1734683
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70963
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 2396905
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70964
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1492746
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70965
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 727542
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70966
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 727545
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70967
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1605455
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70968
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1649946
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70969
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1649964
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 70970
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 993456
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 180