CMS Formulary

Displaying 75001-75010 of 1611142 results.
ID: 75001
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1536490
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75002
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 310878
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75003
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049696
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 75004
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 311982
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75005
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 104884
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75006
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 861430
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75007
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 197939
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75008
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 197940
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75009
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 886662
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75010
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 886666
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0