CMS Formulary

Displaying 72901-72910 of 1611142 results.
ID: 72901
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 207840
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72902
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 2178081
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72903
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 2178077
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72904
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 311671
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72905
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 898367
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72906
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 898378
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72907
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 898372
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72908
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 995278
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72909
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 995253
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72910
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 198228
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0