CMS Formulary

Displaying 73711-73720 of 1611142 results.
ID: 73711
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1190655
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73712
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 545236
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73713
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1724340
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73714
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1244616
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 73715
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 312075
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73716
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 308345
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73717
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 197636
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 73718
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 260243
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73719
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 312641
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73720
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1312625
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0