CMS Formulary

Displaying 72381-72390 of 1611142 results.
ID: 72381
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1595457
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72382
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 2268231
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 30
ID: 72383
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 2268227
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 30
ID: 72384
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 402092
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 72385
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 861637
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72386
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 861206
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72387
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 904170
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72388
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 854859
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72389
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1859000
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 72390
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1604544
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 13
Qty Limit Days: 28