CMS Formulary

Displaying 73361-73370 of 1611142 results.
ID: 73361
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 857564
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73362
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 311892
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73363
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 311893
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73364
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 199521
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 73365
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 198076
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73366
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 198077
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73367
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 198078
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73368
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 198075
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73369
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 313472
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 73370
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 198153
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0