CMS Formulary

Displaying 74511-74520 of 1611142 results.
ID: 74511
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 96304
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74512
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 998689
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74513
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 998685
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74514
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 2099686
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 74515
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 2099691
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 74516
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 2099697
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 74517
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1313785
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74518
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 207588
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74519
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 213510
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74520
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 310386
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0