CMS Formulary

Displaying 81081-81090 of 1611142 results.
ID: 81081
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 242438
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 81082
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 200094
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 81083
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 200095
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 81084
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 200096
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 81085
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 197311
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 81086
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 197313
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 81087
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 313566
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 81088
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 485434
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 81089
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 485436
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 81090
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 859424
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30