CMS Formulary

Displaying 76601-76610 of 1611142 results.
ID: 76601
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1940498
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 76602
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1593831
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 76603
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1593833
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 76604
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1593835
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 76605
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1593775
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 76606
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 861045
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 28
ID: 76607
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 861043
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 28
ID: 76608
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 206347
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76609
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 801357
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76610
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 801112
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0