CMS Formulary

Displaying 73781-73790 of 1611142 results.
ID: 73781
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 226343
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73782
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1191013
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73783
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 308493
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73784
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1116150
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73785
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 310594
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73786
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 905379
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73787
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790533
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 73788
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1791560
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 73789
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1791569
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 73790
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1791576
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30