CMS Formulary

Displaying 81311-81320 of 1611142 results.
ID: 81311
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 861434
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 81312
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 197785
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 81313
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 197803
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 81314
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 861490
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 81315
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 798133
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 81316
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 884520
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 81317
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 755470
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 81318
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 544452
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 81319
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 597768
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 81320
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 597770
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0