CMS Formulary

Displaying 71741-71750 of 1611142 results.
ID: 71741
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 388311
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71742
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 200133
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71743
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 200131
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71744
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 861237
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 71745
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 861221
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 71746
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 861223
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 71747
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 861225
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 71748
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 861227
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 71749
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 861232
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 71750
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1367436
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28