CMS Formulary

Displaying 73641-73650 of 1611142 results.
ID: 73641
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 197848
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73642
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 855926
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 73643
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 855906
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 73644
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 855664
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 73645
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 995281
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73646
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1095227
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73647
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1304988
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73648
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1661092
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 84
ID: 73649
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 309079
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73650
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1438778
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0