CMS Formulary

Displaying 79531-79540 of 1611142 results.
ID: 79531
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 213282
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79532
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 213283
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79533
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 213284
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79534
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 859865
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79535
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 352297
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79536
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 731328
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79537
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 404460
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79538
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1593140
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79539
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1547575
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 79540
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1547110
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30