CMS Formulary

Displaying 79041-79050 of 1611142 results.
ID: 79041
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 995599
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79042
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 995607
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79043
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 307650
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79044
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 616402
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 79045
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 309097
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79046
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 309098
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79047
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 835572
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79048
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 835591
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79049
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 835577
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79050
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 312940
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0