CMS Formulary

Displaying 73771-73780 of 1611142 results.
ID: 73771
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1988399
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 5
Qty Limit Days: 30
ID: 73772
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1150836
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73773
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 2118539
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73774
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 864650
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73775
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 308511
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73776
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1375922
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73777
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 863042
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73778
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 204423
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73779
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 310687
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73780
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 314165
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0