CMS Formulary

Displaying 75141-75150 of 1611142 results.
ID: 75141
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1670322
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 28
ID: 75142
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 977923
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 75143
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 977929
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 75144
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 977874
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 75145
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 977894
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 75146
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 977902
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 75147
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 977909
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 75148
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 977915
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 75149
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 309952
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75150
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 197622
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0