CMS Formulary

Displaying 82251-82260 of 1611142 results.
ID: 82251
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 855873
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 82252
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 2360548
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 82253
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 308989
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 82254
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 308988
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 82255
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 197443
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 82256
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099678
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 82257
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099870
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 82258
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1356563
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 82259
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1356572
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 82260
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1356576
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30