CMS Formulary

Displaying 76301-76310 of 1611142 results.
ID: 76301
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 197454
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76302
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 308177
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76303
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 598025
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76304
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 617309
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76305
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 617316
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76306
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 617296
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76307
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 757707
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 76308
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 403957
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 76309
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 636664
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76310
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 608328
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0