CMS Formulary

Displaying 74931-74940 of 1611142 results.
ID: 74931
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243229
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74932
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 616148
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74933
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 901614
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74934
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1147337
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74935
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1306298
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74936
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1551999
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 74937
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1484922
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 74938
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 2203999
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 74939
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 2204092
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 74940
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544471
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30