CMS Formulary

Displaying 81341-81350 of 1611142 results.
ID: 81341
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 2200183
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 81342
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 2167575
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 81343
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 2167563
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 81344
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 2167567
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 81345
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 2167571
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 81346
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1648755
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 81347
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 725021
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 81348
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 725023
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 81349
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 311994
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 81350
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 311995
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30