CMS Formulary

Displaying 75991-76000 of 1611142 results.
ID: 75991
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1595292
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75992
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1995479
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75993
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1595457
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75994
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 2268231
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 30
ID: 75995
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 2268227
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 30
ID: 75996
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 402092
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 75997
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 861637
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75998
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 861206
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75999
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 904170
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76000
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 854859
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0