CMS Formulary

Displaying 76901-76910 of 1611142 results.
ID: 76901
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 751871
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76902
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 751870
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76903
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 762007
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76904
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 751885
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76905
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 753481
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76906
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 762333
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76907
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 751890
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76908
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1358780
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76909
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1358765
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76910
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1359030
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0