CMS Formulary

Displaying 76401-76410 of 1611142 results.
ID: 76401
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 856660
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76402
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 856652
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76403
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 351133
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76404
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 313979
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76405
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 834127
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76406
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 141935
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76407
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 849385
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76408
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 861848
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76409
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 859835
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76410
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 905273
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0