CMS Formulary

Displaying 76561-76570 of 1611142 results.
ID: 76561
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 834350
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76562
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801299
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76563
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 832731
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76564
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801295
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76565
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123111
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 13
Qty Limit Days: 30
ID: 76566
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 198071
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76567
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 197541
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 76568
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 753478
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76569
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 753479
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76570
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1428933
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0