CMS Formulary

Displaying 79281-79290 of 1611142 results.
ID: 79281
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 310430
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 79282
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 310459
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79283
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 828320
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79284
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 314285
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79285
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 198006
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79286
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 198007
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79287
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 198008
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79288
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 200311
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79289
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 310431
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 79290
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 728113
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 48
Qty Limit Days: 180