CMS Formulary

Displaying 76371-76380 of 1611142 results.
ID: 76371
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 313993
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 76372
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 310293
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 76373
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 310294
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 76374
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 314000
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76375
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 310536
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76376
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 310539
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76377
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1299903
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76378
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 2000695
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76379
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1299909
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76380
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 197507
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0