CMS Formulary

Displaying 81101-81110 of 1611142 results.
ID: 81101
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 312078
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 81102
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 314154
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 81103
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 283639
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 81104
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 200284
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 81105
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 312076
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 81106
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 351108
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 81107
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 349251
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 81108
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 905041
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 81109
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 905092
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 81110
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 905100
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28