CMS Formulary

Displaying 74811-74820 of 1611142 results.
ID: 74811
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 309337
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74812
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 197388
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74813
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 197980
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74814
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 544455
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74815
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 617322
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74816
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 863599
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74817
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 995241
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74818
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 309686
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74819
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 312055
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 900
Qty Limit Days: 30
ID: 74820
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1085745
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0