CMS Formulary

Displaying 71711-71720 of 1611142 results.
ID: 71711
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1373745
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71712
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 485442
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 71713
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 485465
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 71714
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 352066
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 71715
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 656660
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 71716
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1989085
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 71717
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1442143
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 71718
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1729053
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 71719
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1729057
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 71720
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1729061
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30