CMS Formulary

Displaying 73141-73150 of 1611142 results.
ID: 73141
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 2001565
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 73142
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 2001566
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 73143
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 2001568
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 73144
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 993781
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 73145
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049221
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 73146
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049225
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 73147
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049214
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 73148
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091497
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 73149
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091392
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 73150
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091145
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30