CMS Formulary

Displaying 75281-75290 of 1611142 results.
ID: 75281
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 251872
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 75282
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 314200
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 75283
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 349483
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75284
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 349199
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75285
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 349200
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75286
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 200224
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75287
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 898350
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75288
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 898353
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75289
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 898356
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75290
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 898359
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0