CMS Formulary

Displaying 78071-78080 of 1611142 results.
ID: 78071
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 856460
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78072
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 856481
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78073
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 860654
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78074
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 866144
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78075
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 199450
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 78076
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 246172
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 78077
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1606337
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 78078
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 313498
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78079
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 313499
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78080
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 313496
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0