CMS Formulary

Displaying 76181-76190 of 1611142 results.
ID: 76181
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 847741
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 76182
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 835892
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76183
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 2056897
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76184
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 746609
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 76185
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 845518
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 76186
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 845512
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 76187
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 847734
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76188
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 860244
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 15
Qty Limit Days: 30
ID: 76189
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1002300
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 76190
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 998191
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28