CMS Formulary

Displaying 76791-76800 of 1611142 results.
ID: 76791
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 800192
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76792
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665021
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76793
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 309090
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76794
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 309092
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76795
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665005
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76796
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 311683
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76797
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 727575
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76798
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1040012
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76799
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1040016
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76800
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653470
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0