CMS Formulary

Displaying 78161-78170 of 1611142 results.
ID: 78161
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 199655
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78162
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 349208
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78163
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 360110
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78164
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 799055
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78165
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 799056
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78166
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 799054
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78167
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 206913
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78168
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 206917
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78169
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1657151
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 78170
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 994008
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30