CMS Formulary

Displaying 75781-75790 of 1611142 results.
ID: 75781
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 2283515
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 75782
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 2283518
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 75783
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 2283509
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 75784
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 2283513
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 75785
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 2283538
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75786
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 2283536
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75787
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 2283540
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75788
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 311944
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75789
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1999314
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75790
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1999316
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0