CMS Formulary

Displaying 73881-73890 of 1611142 results.
ID: 73881
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 312076
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 73882
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 351108
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 73883
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 349251
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73884
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 905041
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 73885
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 905092
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 73886
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 905100
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 73887
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 153822
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73888
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 153823
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73889
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 639537
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73890
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 578325
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0