CMS Formulary

Displaying 72851-72860 of 1611142 results.
ID: 72851
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 2398842
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 72852
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1991311
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 72853
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1991317
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 72854
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 2200654
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 72855
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 2200658
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 72856
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 2200650
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 72857
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653204
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 72858
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 351926
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28
ID: 72859
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 849851
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72860
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 847247
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0