CMS Formulary

Displaying 81411-81420 of 1611142 results.
ID: 81411
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 199369
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 81412
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 861164
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 81413
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 861171
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 81414
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 645037
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 81415
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000064
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 81416
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 197987
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 81417
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 197986
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 81418
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 860215
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 81419
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 860221
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 81420
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 198056
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0