CMS Formulary

Displaying 76291-76300 of 1611142 results.
ID: 76291
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 855296
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76292
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 855332
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76293
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 855344
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76294
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 242461
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76295
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 242462
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76296
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 856467
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76297
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 311666
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76298
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 311668
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76299
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 314234
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76300
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 309115
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0