CMS Formulary

Displaying 78911-78920 of 1611142 results.
ID: 78911
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 833528
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78912
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 722134
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78913
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 722137
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78914
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 722126
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78915
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 722131
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78916
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 860715
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 78917
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 860695
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 78918
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 860707
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 78919
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 309058
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78920
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 419849
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0