CMS Formulary

Displaying 78011-78020 of 1611142 results.
ID: 78011
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 310379
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78012
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 310380
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78013
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1313112
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78014
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1370770
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 78015
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 855671
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78016
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 311679
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78017
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 105583
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78018
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 199378
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78019
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 402505
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78020
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 402506
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0