CMS Formulary

Displaying 72681-72690 of 1611142 results.
ID: 72681
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 855344
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72682
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 242461
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72683
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 242462
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72684
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 856467
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72685
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 311666
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72686
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 311668
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72687
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 314234
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72688
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 309115
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72689
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 197454
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72690
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 308177
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0