CMS Formulary

Displaying 79021-79030 of 1611142 results.
ID: 79021
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 2044720
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 79022
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 2044726
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 79023
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 2044732
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 79024
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 2046376
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79025
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 2046380
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79026
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 2046370
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79027
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 311288
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79028
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 311289
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79029
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 387003
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79030
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 807832
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0