CMS Formulary

Displaying 74161-74170 of 1611142 results.
ID: 74161
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 865212
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 74162
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 865216
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 74163
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 723827
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74164
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 729201
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74165
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 729203
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74166
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1796079
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74167
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1796083
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74168
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1433879
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74169
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1546894
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74170
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1857913
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0