CMS Formulary

Displaying 79091-79100 of 1611142 results.
ID: 79091
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 854880
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 79092
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 672149
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79093
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 477347
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79094
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 642452
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79095
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 602635
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79096
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1736654
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79097
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1736656
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79098
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806683
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79099
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806684
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79100
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1356074
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0