CMS Formulary

Displaying 72581-72590 of 1611142 results.
ID: 72581
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1310138
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 72582
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1310144
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 72583
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1310147
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 72584
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364114
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 72585
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364118
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 72586
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364122
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 72587
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653243
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72588
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1599797
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72589
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1603361
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72590
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1603365
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0