CMS Formulary

Displaying 76151-76160 of 1611142 results.
ID: 76151
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1921245
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76152
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1726846
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76153
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 847745
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 76154
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1872980
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76155
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1747577
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 76156
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1747579
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 76157
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1747567
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 76158
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1747580
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76159
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1921017
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76160
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1921010
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0