CMS Formulary

Displaying 74821-74830 of 1611142 results.
ID: 74821
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 992432
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74822
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000054
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74823
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 831215
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74824
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 831252
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74825
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 831285
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74826
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 312301
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74827
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 197684
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74828
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 197685
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74829
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 859186
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74830
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 197625
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0