CMS Formulary

Displaying 76631-76640 of 1611142 results.
ID: 76631
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 197464
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 76632
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 856840
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76633
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 197436
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76634
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 197437
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76635
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 197438
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76636
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 197439
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76637
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1298861
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76638
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1298870
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76639
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 856769
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76640
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 314034
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0