CMS Formulary

Displaying 75271-75280 of 1611142 results.
ID: 75271
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 198188
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75272
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 313134
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75273
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 562508
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75274
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 617430
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75275
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 199884
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75276
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 311296
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75277
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 200285
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75278
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 349353
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75279
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 636042
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 75280
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 636045
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0