CMS Formulary

Displaying 76231-76240 of 1611142 results.
ID: 76231
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923056
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 70
Qty Limit Days: 28
ID: 76232
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923058
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 28
ID: 76233
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 2002719
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 76234
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058981
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 76235
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123314
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76236
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 2121096
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 76237
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 2121100
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 76238
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 2390954
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 76239
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 545293
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76240
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 207029
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0