CMS Formulary

Displaying 76891-76900 of 1611142 results.
ID: 76891
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000135
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76892
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000141
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76893
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 197658
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76894
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 197659
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76895
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 197657
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76896
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 541878
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 76897
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 541892
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 76898
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 577961
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 76899
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 541363
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 76900
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 751868
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0