CMS Formulary

Displaying 72511-72520 of 1611142 results.
ID: 72511
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 616283
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 72512
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 2284106
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 72513
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 616287
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 72514
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1541928
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 72515
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 616292
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 72516
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1357547
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72517
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 2048568
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72518
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 2478437
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72519
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 2099956
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 72520
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058926
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30