CMS Formulary

Displaying 78701-78710 of 1611142 results.
ID: 78701
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 312070
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78702
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1117522
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78703
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1664981
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78704
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 859871
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78705
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 204416
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78706
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1722934
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78707
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1807632
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78708
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1795609
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78709
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1795477
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78710
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 581531
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0