CMS Formulary

Displaying 74281-74290 of 1611142 results.
ID: 74281
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1439894
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 74282
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1439896
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 74283
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1439899
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 74284
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1439901
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 74285
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1439903
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 74286
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 2105657
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 74287
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 2105645
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 74288
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 2105653
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 74289
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 2180336
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 74290
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 615979
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30