CMS Formulary

Displaying 72431-72440 of 1611142 results.
ID: 72431
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 997296
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 72432
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 310792
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72433
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 310793
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72434
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 835589
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72435
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 477234
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72436
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 199519
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72437
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 197624
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72438
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1437968
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72439
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1437969
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72440
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 897657
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1200
Qty Limit Days: 30