CMS Formulary

Displaying 71361-71370 of 1611142 results.
ID: 71361
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1738807
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71362
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 897584
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71363
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 897590
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71364
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 897596
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71365
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 317769
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71366
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 314208
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71367
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 312847
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71368
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 205284
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71369
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 205285
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71370
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 643019
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30