CMS Formulary

Displaying 71781-71790 of 1611142 results.
ID: 71781
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 311204
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71782
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 898715
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 900
Qty Limit Days: 30
ID: 71783
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 282755
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71784
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 205304
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71785
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 205305
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71786
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 409823
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71787
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 892582
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 71788
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 892672
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 71789
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923822
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71790
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923828
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0