CMS Formulary

Displaying 76051-76060 of 1611142 results.
ID: 76051
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1437969
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76052
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 897657
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1200
Qty Limit Days: 30
ID: 76053
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049604
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1300
Qty Limit Days: 30
ID: 76054
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1874559
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 76055
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1874553
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 76056
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 900575
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76057
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 977427
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76058
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 977434
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76059
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 977438
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76060
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 892625
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30