CMS Formulary

Displaying 75711-75720 of 1611142 results.
ID: 75711
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 2001439
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 75712
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1437713
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75713
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1918242
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 75714
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1862595
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 75715
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1921589
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 75716
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1862590
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 75717
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1666545
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75718
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1666542
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75719
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 831246
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75720
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 2380617
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30