CMS Formulary

Displaying 76011-76020 of 1611142 results.
ID: 76011
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1797880
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76012
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1113046
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76013
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 863836
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76014
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 863841
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76015
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 863829
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76016
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1373327
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76017
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 905164
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76018
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 688242
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76019
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 208513
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76020
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 404550
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0