CMS Formulary

Displaying 76031-76040 of 1611142 results.
ID: 76031
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1797833
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 76032
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1797844
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 15
Qty Limit Days: 10
ID: 76033
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 885857
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76034
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 860901
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 200
Qty Limit Days: 30
ID: 76035
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 351265
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 76036
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 351266
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 76037
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 351267
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 76038
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 905172
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76039
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 905168
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76040
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 892589
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 700
Qty Limit Days: 30