CMS Formulary

Displaying 76671-76680 of 1611142 results.
ID: 76671
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 876514
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76672
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 876529
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76673
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 876519
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76674
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 312593
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76675
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 966220
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76676
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 966221
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76677
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 966222
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76678
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 966253
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76679
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 892246
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76680
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 966248
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0