CMS Formulary

Displaying 71421-71430 of 1611142 results.
ID: 71421
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099870
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71422
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1356563
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 71423
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1356572
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 71424
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1356576
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 71425
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1356580
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 71426
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1356584
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 71427
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1356588
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 71428
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790126
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 720
Qty Limit Days: 30
ID: 71429
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 824299
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71430
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 824303
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0