CMS Formulary

Displaying 99071-99080 of 1611142 results.
ID: 99071
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790533
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 99072
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1791560
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 99073
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1791569
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 99074
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1791576
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 99075
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1791582
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 99076
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1812015
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99077
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 862006
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99078
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 862013
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99079
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 862019
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99080
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 862025
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0