CMS Formulary

Displaying 73081-73090 of 1611142 results.
ID: 73081
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000070
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73082
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1536586
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 73083
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 242333
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 73084
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 241527
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 73085
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 403922
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 73086
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 402109
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73087
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 834235
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 73088
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 834241
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 73089
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 359144
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73090
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 359145
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0