CMS Formulary

Displaying 76041-76050 of 1611142 results.
ID: 76041
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 894780
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 76042
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 997287
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 76043
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 997296
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 76044
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 310792
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76045
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 310793
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76046
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 835589
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76047
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 477234
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76048
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 199519
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76049
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 197624
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76050
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1437968
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0