CMS Formulary

Displaying 71-80 of 1611142 results.
ID: 71
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1988675
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 72
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1924315
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1486841
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 798300
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 830253
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 830245
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 836636
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 836634
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1597099
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 365
ID: 80
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1597103
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 365