CMS Formulary

Displaying 71371-71380 of 1611142 results.
ID: 71371
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 643022
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 71372
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 866482
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71373
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 866479
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71374
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 349401
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71375
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 349405
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71376
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 205322
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 71377
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 205323
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 71378
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 403853
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71379
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 403854
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71380
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 403855
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0