CMS Formulary

Displaying 76281-76290 of 1611142 results.
ID: 76281
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 904589
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76282
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 309043
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76283
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 894859
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76284
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 866042
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76285
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 855288
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76286
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 855302
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76287
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 855312
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76288
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 855318
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76289
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 855324
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76290
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 855338
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0