CMS Formulary

Displaying 72171-72180 of 1611142 results.
ID: 72171
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 2283509
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 72172
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 2283513
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 72173
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 2283538
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72174
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 2283536
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72175
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 2283540
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72176
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 311944
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72177
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1999314
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72178
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 1999316
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72179
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058520
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 72180
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058525
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28