CMS Formulary

Displaying 72341-72350 of 1611142 results.
ID: 72341
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 836636
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72342
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 836634
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72343
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1597099
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 365
ID: 72344
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1597103
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 365
ID: 72345
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1292443
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72346
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 804186
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72347
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1292459
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 365
ID: 72348
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1658106
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72349
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1658102
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72350
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 798451
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0