CMS Formulary

Displaying 76131-76140 of 1611142 results.
ID: 76131
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 2099956
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 76132
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058926
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 76133
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047602
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 76134
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047608
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 76135
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047614
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 76136
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047596
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 76137
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047623
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 76138
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 2463737
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 76139
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 2463733
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 76140
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 2105856
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30