CMS Formulary

Displaying 73491-73500 of 1611142 results.
ID: 73491
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 617423
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73492
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 617993
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73493
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 314227
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 73494
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 142046
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73495
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 244374
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73496
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 238004
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 73497
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 313921
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 73498
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 238003
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 73499
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 403923
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 73500
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 241946
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28