CMS Formulary

Displaying 73261-73270 of 1611142 results.
ID: 73261
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 349196
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 73262
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 349197
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 73263
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 905516
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 73264
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 905495
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 73265
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 835913
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73266
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000405
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73267
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 995232
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73268
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 977883
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73269
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 197863
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73270
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 197556
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0