CMS Formulary

Displaying 78351-78360 of 1611142 results.
ID: 78351
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 2396770
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 14
Qty Limit Days: 28
ID: 78352
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 2396774
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 14
Qty Limit Days: 28
ID: 78353
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 2288433
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78354
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 2288412
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 78355
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 2288431
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78356
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 727816
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 78357
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650901
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 78358
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 2054995
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 7
Qty Limit Days: 7
ID: 78359
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123137
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 84
Qty Limit Days: 28
ID: 78360
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123141
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28