CMS Formulary

Displaying 78861-78870 of 1611142 results.
ID: 78861
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 979485
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78862
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 979492
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78863
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 979480
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78864
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 248109
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78865
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 314108
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78866
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 311290
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78867
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 854984
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78868
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 854988
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78869
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 854925
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78870
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 857166
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0