CMS Formulary

Displaying 72261-72270 of 1611142 results.
ID: 72261
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 861659
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72262
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 861661
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72263
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 861663
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72264
Formulary ID: 00021025
Formulary Version: 14
Contract Year: 2021
RXCUI: 545278
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72265
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1551300
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 72266
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1551306
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 72267
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058877
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 30
ID: 72268
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1745108
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72269
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 2395779
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 72270
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058887
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 30