CMS Formulary

Displaying 75521-75530 of 1611142 results.
ID: 75521
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1738483
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75522
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1738495
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75523
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1738503
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75524
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099596
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75525
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 197412
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75526
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 312828
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 75527
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 312829
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 75528
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 312830
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 75529
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 312831
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 75530
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 312832
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30