CMS Formulary

Displaying 75091-75100 of 1611142 results.
ID: 75091
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1664981
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75092
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 859871
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75093
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 204416
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75094
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1722934
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75095
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1807632
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75096
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1795609
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75097
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1795477
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75098
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 581531
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75099
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 2371050
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 75100
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 2371054
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30