CMS Formulary

Displaying 82621-82630 of 1611142 results.
ID: 82621
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 205305
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 82622
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 409823
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 82623
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 892582
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 82624
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 892672
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 82625
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923822
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 82626
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923828
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 82627
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923826
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 82628
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1490026
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 82629
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1490034
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 82630
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1490038
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30