CMS Formulary

Displaying 75221-75230 of 1611142 results.
ID: 75221
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 308182
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75222
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 283406
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75223
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 283407
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75224
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 283485
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75225
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 756209
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75226
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 311943
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75227
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 313850
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75228
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 313222
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75229
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 861743
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75230
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 861748
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0