CMS Formulary

Displaying 78271-78280 of 1611142 results.
ID: 78271
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 830557
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78272
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 803371
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78273
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1300810
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78274
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 798430
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78275
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 798428
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78276
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1986830
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 365
ID: 78277
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 798482
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78278
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 798479
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78279
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1300378
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78280
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1300370
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0