CMS Formulary

Displaying 81401-81410 of 1611142 results.
ID: 81401
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790146
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 81402
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 197839
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 81403
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 313447
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 81404
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 835593
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 81405
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 835564
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 81406
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 835568
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 81407
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 197739
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 81408
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 861156
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 81409
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 896758
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 81410
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 896762
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0