CMS Formulary

Displaying 72821-72830 of 1611142 results.
ID: 72821
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1649988
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72822
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 308189
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72823
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 313797
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72824
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 239191
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72825
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665052
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72826
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665444
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72827
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665449
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72828
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 313920
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72829
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 106258
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72830
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 203105
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0