CMS Formulary

Displaying 79141-79150 of 1611142 results.
ID: 79141
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 312831
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 79142
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 312832
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 79143
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 314211
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 79144
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 199890
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79145
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 845488
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79146
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 861736
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 79147
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 861740
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 79148
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 312817
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79149
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 577315
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79150
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 577317
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0