CMS Formulary

Displaying 75351-75360 of 1611142 results.
ID: 75351
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1011736
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75352
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1011739
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75353
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 388311
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75354
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 200133
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75355
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 200131
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75356
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 861237
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 75357
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 861221
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 75358
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 861223
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 75359
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 861225
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 75360
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 861227
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30