CMS Formulary

Displaying 82481-82490 of 1611142 results.
ID: 82481
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 854925
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 82482
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 857166
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 82483
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 857174
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 82484
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 904431
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 82485
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 312087
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 82486
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 198334
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 82487
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 198335
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 82488
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 433798
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 82489
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 433800
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 82490
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 433799
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30