CMS Formulary

Displaying 74891-74900 of 1611142 results.
ID: 74891
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 854801
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74892
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 313477
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74893
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 861200
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74894
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 861208
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74895
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000647
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74896
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000862
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74897
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000897
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74898
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923428
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74899
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 831109
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 74900
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 978573
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0