CMS Formulary

Displaying 76921-76930 of 1611142 results.
ID: 76921
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 750267
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76922
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1095229
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76923
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 857560
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76924
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 898362
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76925
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 312529
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76926
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 977880
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76927
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047882
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76928
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 310190
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76929
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 310191
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 76930
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 261178
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30