CMS Formulary

Displaying 74101-74110 of 1611142 results.
ID: 74101
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 105292
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74102
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1943345
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74103
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 2053458
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74104
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 199592
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 74105
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 483090
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74106
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 476399
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74107
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 476515
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74108
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 805464
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 74109
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659927
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74110
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 2056748
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 25