CMS Formulary

Displaying 71191-71200 of 1611142 results.
ID: 71191
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 141963
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71192
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 198317
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 71193
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 198318
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 71194
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000126
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 84
ID: 71195
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000153
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 84
ID: 71196
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 198232
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71197
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 311727
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71198
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 317128
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71199
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 309337
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71200
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 197388
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0