CMS Formulary

Displaying 79421-79430 of 1611142 results.
ID: 79421
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 483438
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 79422
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 483440
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 79423
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 483444
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 79424
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 2178403
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 79425
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 2178405
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 28
ID: 79426
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 2382990
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 24
Qty Limit Days: 28
ID: 79427
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 2178407
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 32
Qty Limit Days: 28
ID: 79428
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 2178409
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 20
Qty Limit Days: 28
ID: 79429
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 2382991
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 28
ID: 79430
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 2382993
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28