CMS Formulary

Displaying 76611-76620 of 1611142 results.
ID: 76611
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 801136
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76612
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1799706
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76613
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 805131
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76614
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 801648
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76615
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 800420
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76616
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 800405
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76617
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1090639
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76618
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 800438
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76619
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 800444
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76620
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 801012
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0