CMS Formulary

Displaying 81491-81500 of 1611142 results.
ID: 81491
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 312614
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 81492
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 283077
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 81493
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 993755
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4500
Qty Limit Days: 30
ID: 81494
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 197448
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 81495
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923432
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 81496
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 578018
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 81497
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 477391
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 81498
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 197877
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 81499
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1010739
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 81500
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 391937
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0