CMS Formulary

Displaying 73551-73560 of 1611142 results.
ID: 73551
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 795918
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73552
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 993541
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73553
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 993557
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73554
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 996097
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73555
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 996615
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 73556
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 996594
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 73557
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 996603
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 73558
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 996609
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 73559
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1540356
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73560
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 992475
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0