CMS Formulary

Displaying 74831-74840 of 1611142 results.
ID: 74831
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 197626
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74832
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 197627
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74833
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 197628
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74834
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 199390
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74835
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 197553
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74836
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 328160
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74837
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 310490
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 74838
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 310488
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 74839
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 993687
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74840
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 993691
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0