CMS Formulary

Displaying 78081-78090 of 1611142 results.
ID: 78081
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1111110
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 20
Qty Limit Days: 10
ID: 78082
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 2279847
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 10
ID: 78083
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1001690
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78084
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 2465556
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78085
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 905394
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78086
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 404539
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78087
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1115012
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 78088
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1115013
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 78089
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091632
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78090
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091629
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0