CMS Formulary

Displaying 78141-78150 of 1611142 results.
ID: 78141
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1373335
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78142
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1373337
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78143
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 312084
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78144
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 198051
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78145
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 312077
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 78146
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 313412
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78147
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 313413
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78148
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 314286
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 78149
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 313776
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 78150
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 313777
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30