CMS Formulary

Displaying 79801-79810 of 1611142 results.
ID: 79801
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1002300
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 79802
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 998191
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 79803
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1012899
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 79804
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1119402
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 79805
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1310138
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 79806
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1310144
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 79807
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1310147
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 79808
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364114
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 79809
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364118
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 79810
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364122
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30