CMS Formulary

Displaying 71701-71710 of 1611142 results.
ID: 71701
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 724859
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 71702
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 724861
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 71703
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 403818
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71704
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 730869
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71705
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 897021
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 71706
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049264
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 84
ID: 71707
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1856424
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71708
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 2052064
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71709
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 861375
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71710
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 861370
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0