CMS Formulary

Displaying 82891-82900 of 1611142 results.
ID: 82891
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1373497
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 82892
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 403875
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 82893
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 310430
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 82894
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 310459
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 82895
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 828320
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 82896
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 314285
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 82897
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 198006
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 82898
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 198007
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 82899
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 198008
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 82900
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 200311
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0