CMS Formulary

Displaying 73871-73880 of 1611142 results.
ID: 73871
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 199193
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73872
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 198382
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73873
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 997226
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 73874
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 997220
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 73875
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 349201
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73876
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 200034
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 73877
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 312078
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 73878
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 314154
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 73879
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 283639
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 73880
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 200284
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0