CMS Formulary

Displaying 74091-74100 of 1611142 results.
ID: 74091
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 798133
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74092
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 884520
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 74093
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 755470
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74094
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 544452
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74095
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 597768
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74096
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 597770
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74097
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 597772
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74098
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 403975
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74099
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 259306
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74100
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1799654
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0