CMS Formulary

Displaying 79301-79310 of 1611142 results.
ID: 79301
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243585
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79302
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 313988
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79303
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 198032
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79304
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 309307
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79305
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790684
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79306
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 197854
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79307
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 310003
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79308
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 310004
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79309
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 310005
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79310
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099681
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0