CMS Formulary

Displaying 74441-74450 of 1611142 results.
ID: 74441
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 2468058
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74442
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 2471314
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74443
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653433
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74444
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 748962
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74445
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 831533
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74446
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 993943
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 74447
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 994239
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 74448
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 312138
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74449
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1012904
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74450
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1010696
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0