CMS Formulary

Displaying 76511-76520 of 1611142 results.
ID: 76511
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 2395775
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 76512
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 249066
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76513
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 207840
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76514
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 2178081
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76515
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 2178077
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76516
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 311671
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76517
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 898367
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76518
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 898378
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76519
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 898372
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76520
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 995278
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0