CMS Formulary

Displaying 71441-71450 of 1611142 results.
ID: 71441
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 825325
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71442
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 825334
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71443
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1040025
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 35
Qty Limit Days: 28
ID: 71444
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 212118
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71445
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 542370
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71446
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1988768
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 71447
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1921228
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 71448
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1988772
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 71449
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1988786
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71450
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1723763
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28