CMS Formulary

Displaying 71861-71870 of 1611142 results.
ID: 71861
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 848140
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71862
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 848131
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71863
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 848145
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71864
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 848151
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71865
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 848135
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71866
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 854894
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 71867
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 854880
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 71868
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 672149
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71869
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 477347
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71870
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 642452
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0