CMS Formulary

Displaying 78371-78380 of 1611142 results.
ID: 78371
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1600710
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78372
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1999587
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 78373
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364515
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78374
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 2373941
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78375
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049677
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78376
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 762675
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78377
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 259966
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78378
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 197973
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78379
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 401953
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 78380
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 401954
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30