CMS Formulary

Displaying 71381-71390 of 1611142 results.
ID: 71381
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 859981
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 71382
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 859975
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 71383
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 283316
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71384
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 283317
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71385
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 477130
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71386
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 849389
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71387
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 313407
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71388
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 313408
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71389
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1536490
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71390
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 310878
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0