CMS Formulary

Displaying 78301-78310 of 1611142 results.
ID: 78301
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049565
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 78302
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049576
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 78303
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049586
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 78304
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049595
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 78305
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049601
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 78306
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544404
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78307
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544383
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78308
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544386
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78309
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544388
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78310
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544390
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0