CMS Formulary

Displaying 79721-79730 of 1611142 results.
ID: 79721
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 2057205
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79722
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 2057216
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79723
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 2057212
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79724
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 2057219
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79725
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 2099952
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 79726
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 2105860
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 79727
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 2469340
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79728
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 637188
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 336
Qty Limit Days: 365
ID: 79729
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 795735
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 336
Qty Limit Days: 365
ID: 79730
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 637190
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 336
Qty Limit Days: 365