CMS Formulary

Displaying 73101-73110 of 1611142 results.
ID: 73101
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 830869
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73102
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 830872
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73103
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 260350
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73104
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 260351
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73105
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 432401
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 73106
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000058
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73107
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 226552
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 73108
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 748878
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73109
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1111641
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 73110
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1487361
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28