CMS Formulary

Displaying 78281-78290 of 1611142 results.
ID: 78281
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 805579
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78282
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 901518
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78283
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 830463
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78284
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1601407
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78285
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 809159
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78286
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 802652
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78287
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653225
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78288
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 2182340
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78289
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 2392142
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78290
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 261105
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0