CMS Formulary

Displaying 79731-79740 of 1611142 results.
ID: 79731
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 795737
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79732
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 2284104
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 79733
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1741049
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79734
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 2273115
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79735
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 616283
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 79736
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 2284106
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 79737
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 616287
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 79738
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1541928
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 79739
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 616292
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 79740
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1357547
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0