CMS Formulary

Displaying 72401-72410 of 1611142 results.
ID: 72401
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 863836
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72402
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 863841
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72403
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 863829
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72404
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1373327
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72405
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 905164
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72406
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 688242
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72407
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 208513
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72408
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 404550
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72409
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 150840
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72410
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 208949
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0