CMS Formulary

Displaying 74391-74400 of 1611142 results.
ID: 74391
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 858817
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74392
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 858810
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74393
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 308973
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74394
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 858824
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74395
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 858828
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74396
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 308976
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74397
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 834348
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74398
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1370767
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 74399
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 310379
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74400
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 310380
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0