CMS Formulary

Displaying 82351-82360 of 1611142 results.
ID: 82351
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1649593
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 82352
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1546189
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 82353
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 2261794
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 82354
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1040058
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 82355
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 858804
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 82356
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 794641
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 82357
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 902624
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 82358
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 902626
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 82359
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 617768
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 82360
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790892
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30