CMS Formulary

Displaying 75081-75090 of 1611142 results.
ID: 75081
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 597823
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75082
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1726214
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75083
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1721458
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75084
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1721460
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75085
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1726204
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75086
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 312821
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75087
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 204509
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75088
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 312069
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75089
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 312070
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75090
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1117522
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0