CMS Formulary

Displaying 79901-79910 of 1611142 results.
ID: 79901
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 855324
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79902
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 855338
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79903
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 855296
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79904
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 855332
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79905
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 855344
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79906
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 242461
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79907
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 242462
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79908
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 856467
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79909
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 311666
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 79910
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 311668
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0