CMS Formulary

Displaying 78571-78580 of 1611142 results.
ID: 78571
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 831248
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78572
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 831300
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78573
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 831325
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78574
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 831349
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78575
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801298
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78576
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801294
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78577
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1044591
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 78578
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 311192
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78579
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 311197
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78580
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 311196
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0