CMS Formulary

Displaying 75441-75450 of 1611142 results.
ID: 75441
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 197452
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75442
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 197453
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75443
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 309110
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75444
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 309113
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75445
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 200345
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 75446
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 197903
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75447
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 197904
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75448
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 197905
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75449
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 311353
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75450
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 311354
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0