CMS Formulary

Displaying 74051-74060 of 1611142 results.
ID: 74051
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1085636
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74052
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 197735
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 74053
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 543546
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 74054
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1085644
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74055
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1014314
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74056
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1085686
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74057
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1797895
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 74058
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 151030
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74059
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 977990
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74060
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 977978
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0