CMS Formulary

Displaying 73981-73990 of 1611142 results.
ID: 73981
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 857187
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73982
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 197732
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73983
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 312750
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73984
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 312748
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73985
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 312079
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 73986
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 208185
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73987
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 577127
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 73988
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 404013
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73989
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 404011
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 73990
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 597990
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0