CMS Formulary

Displaying 74641-74650 of 1611142 results.
ID: 74641
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 853356
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74642
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 848164
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74643
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653144
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74644
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1482814
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74645
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653166
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74646
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1100079
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 74647
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1918044
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 74648
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1928689
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74649
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 2118741
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74650
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 2000019
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28