CMS Formulary

Displaying 73801-73810 of 1611142 results.
ID: 73801
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 242800
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73802
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1721315
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73803
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1721314
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73804
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1361574
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73805
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 200193
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 30
ID: 73806
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 200194
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 30
ID: 73807
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 616539
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 73808
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 616541
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 73809
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 317094
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73810
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 349435
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0