CMS Formulary

Displaying 72011-72020 of 1611142 results.
ID: 72011
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1812013
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72012
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 562806
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 30
ID: 72013
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 825130
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72014
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 260260
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72015
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1370758
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 72016
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 311382
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72017
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 861668
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 72018
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 830795
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72019
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 831359
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72020
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 801957
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0