CMS Formulary

Displaying 78751-78760 of 1611142 results.
ID: 78751
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 2384465
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 5
Qty Limit Days: 28
ID: 78752
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1670324
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 80
Qty Limit Days: 28
ID: 78753
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1670322
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 28
ID: 78754
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 977923
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 78755
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 977929
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 78756
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 977874
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 78757
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 977894
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 78758
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 977902
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 78759
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 977909
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 78760
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 977915
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30