CMS Formulary

Displaying 73621-73630 of 1611142 results.
ID: 73621
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 856373
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73622
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 900164
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73623
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 850091
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73624
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 850087
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73625
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 310288
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73626
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 197985
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73627
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 197984
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73628
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 598006
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73629
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 197650
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73630
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091155
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30