CMS Formulary

Displaying 81371-81380 of 1611142 results.
ID: 81371
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 2360588
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 81372
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 807225
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 81373
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1486496
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 81374
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 763106
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 81375
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1658241
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 81376
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1939299
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 81377
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1939348
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 81378
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 577324
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 81379
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 727316
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 81380
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1870207
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30