CMS Formulary

Displaying 71651-71660 of 1611142 results.
ID: 71651
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 198335
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71652
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 433798
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 71653
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 433800
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 71654
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 433799
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 71655
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 433801
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 71656
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 979468
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71657
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 979464
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71658
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 979471
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71659
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 198188
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71660
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 313134
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0