CMS Formulary

Displaying 74701-74710 of 1611142 results.
ID: 74701
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544398
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74702
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544402
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74703
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659818
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 74704
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659814
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 74705
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1658325
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 74706
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1658329
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 74707
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1658333
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 74708
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1658337
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 74709
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1658341
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 74710
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1658345
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30