CMS Formulary

Displaying 79331-79340 of 1611142 results.
ID: 79331
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 831246
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79332
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 2380617
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 79333
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 849515
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79334
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 833008
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79335
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 883826
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 79336
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 197943
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79337
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 197944
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79338
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659929
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79339
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 2102705
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79340
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058906
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0