CMS Formulary

Displaying 72121-72130 of 1611142 results.
ID: 72121
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1986331
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 72122
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1918230
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 72123
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 2054269
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72124
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 2362178
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 72125
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 2362182
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 72126
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 432400
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 72127
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1940654
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 72128
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1944382
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 72129
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1944376
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 72130
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1921081
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30