CMS Formulary

Displaying 78981-78990 of 1611142 results.
ID: 78981
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 861356
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78982
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1737244
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78983
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1737581
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78984
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 2048025
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78985
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 404419
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78986
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 106351
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78987
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 198241
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 78988
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 198242
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 78989
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 308136
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 78990
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 197361
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0