CMS Formulary

Displaying 71681-71690 of 1611142 results.
ID: 71681
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 562266
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71682
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 863669
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71683
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 313581
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 71684
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 402246
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71685
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 402247
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71686
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 664741
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71687
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 833528
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71688
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 722134
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71689
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 722137
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71690
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 722126
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0