CMS Formulary

Displaying 73861-73870 of 1611142 results.
ID: 73861
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 197311
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73862
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 197313
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73863
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 313566
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73864
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 485434
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73865
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 485436
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73866
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 859424
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 73867
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 859747
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 73868
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 859751
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 73869
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 859419
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 73870
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 199192
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0