CMS Formulary

Displaying 78391-78400 of 1611142 results.
ID: 78391
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 857706
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78392
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1359105
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78393
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 328161
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78394
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 197971
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78395
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 861064
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78396
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 197787
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78397
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 197782
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78398
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 197783
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78399
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 313142
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78400
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 312347
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0