CMS Formulary

Displaying 74851-74860 of 1611142 results.
ID: 74851
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 284008
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 25
ID: 74852
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 313919
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 74853
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1797865
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 34
Qty Limit Days: 28
ID: 74854
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1797867
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 25
ID: 74855
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 860107
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 25
ID: 74856
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 904481
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74857
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 617312
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74858
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 617310
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74859
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 617311
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74860
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 310818
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0