CMS Formulary

Displaying 74031-74040 of 1611142 results.
ID: 74031
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 2122648
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74032
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 2122642
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74033
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 2477272
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 74034
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 795749
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74035
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1809520
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74036
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 239189
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74037
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665107
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74038
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 309072
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74039
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 863538
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74040
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665507
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0