CMS Formulary

Displaying 73661-73670 of 1611142 results.
ID: 73661
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1607784
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73662
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 199245
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 73663
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 199246
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 73664
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 199247
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 73665
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 314231
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 73666
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 312961
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 73667
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 198211
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 73668
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 200060
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73669
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 317573
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 73670
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 312440
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30