CMS Formulary

Displaying 81971-81980 of 1611142 results.
ID: 81971
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123137
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 84
Qty Limit Days: 28
ID: 81972
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123141
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 81973
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123145
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 81974
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1102277
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 81975
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 794610
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 81976
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 831870
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 81977
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 850457
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 81978
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1236632
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 81979
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1359271
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 81980
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 758555
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0