CMS Formulary

Displaying 75801-75810 of 1611142 results.
ID: 75801
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 2199304
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75802
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 2199308
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75803
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 2199312
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75804
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 2199316
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75805
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 206883
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75806
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 2473107
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75807
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 206902
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75808
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 483450
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 75809
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 483438
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 75810
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 483440
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30