CMS Formulary

Displaying 73941-73950 of 1611142 results.
ID: 73941
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 848738
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 73942
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 848742
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 73943
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 848746
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 73944
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 848750
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 73945
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 848730
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 73946
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 848734
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 73947
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 848752
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73948
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1491624
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 73949
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 2468316
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 73950
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 2381144
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0