CMS Formulary

Displaying 75771-75780 of 1611142 results.
ID: 75771
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1421461
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75772
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 2044928
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 75773
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 2044932
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 75774
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049884
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 75775
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 2045959
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 75776
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 2045961
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 75777
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 2045958
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 75778
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 2055286
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75779
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 2265701
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 75780
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 2283505
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30