CMS Formulary

Displaying 76681-76690 of 1611142 results.
ID: 76681
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 966224
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76682
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 966225
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76683
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 966249
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76684
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 892251
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76685
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 892255
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76686
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 966270
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76687
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 349477
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76688
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 198324
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76689
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 198325
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76690
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 198323
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0