CMS Formulary

Displaying 81901-81910 of 1611142 results.
ID: 81901
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 2392142
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 81902
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 261105
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 81903
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1310531
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 81904
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1310535
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 81905
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1547231
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 81906
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 2110618
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 81907
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1114074
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 81908
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1114096
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 81909
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 903841
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 81910
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1114470
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30