CMS Formulary

Displaying 73011-73020 of 1611142 results.
ID: 73011
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 801031
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73012
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 866924
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73013
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 197465
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 73014
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 197466
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 73015
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 856720
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73016
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 197505
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73017
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 198286
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73018
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1298857
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73019
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 197464
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 73020
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 856840
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0