CMS Formulary

Displaying 79651-79660 of 1611142 results.
ID: 79651
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 905168
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79652
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 892589
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 700
Qty Limit Days: 30
ID: 79653
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 894780
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 79654
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 997287
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 79655
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 997296
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 79656
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 310792
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79657
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 310793
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79658
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 835589
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79659
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 477234
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79660
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 199519
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0