CMS Formulary

Displaying 74081-74090 of 1611142 results.
ID: 74081
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1540241
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74082
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1597076
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 74083
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 992441
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74084
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 992454
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74085
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1053753
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74086
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1006688
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74087
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 861434
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74088
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 197785
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74089
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 197803
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74090
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 861490
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0