CMS Formulary

Displaying 71881-71890 of 1611142 results.
ID: 71881
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1543553
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71882
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1422081
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71883
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1427300
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71884
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 748800
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71885
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1599949
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 71886
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 848180
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 71887
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 141850
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 71888
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 197573
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 71889
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123072
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 17
Qty Limit Days: 30
ID: 71890
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 314076
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0