CMS Formulary

Displaying 82271-82280 of 1611142 results.
ID: 82271
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1604350
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 82272
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1792393
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 82273
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1604395
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 82274
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1604352
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 82275
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 825335
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 82276
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 825333
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 82277
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 825325
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 82278
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 825334
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 82279
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1040025
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 35
Qty Limit Days: 28
ID: 82280
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 212118
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0