CMS Formulary

Displaying 76541-76550 of 1611142 results.
ID: 76541
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 312134
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 76542
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 198059
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 76543
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 198033
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76544
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 197444
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76545
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 197445
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76546
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 197816
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76547
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 197815
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76548
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1001004
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76549
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 351264
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 76550
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 904605
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0