CMS Formulary

Displaying 82001-82010 of 1611142 results.
ID: 82001
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 313219
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 82002
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 260376
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 82003
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 857706
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 82004
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1359105
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 82005
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 328161
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 82006
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 197971
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 82007
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 861064
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 82008
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 197787
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 82009
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 197782
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 82010
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 197783
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0