CMS Formulary

Displaying 82921-82930 of 1611142 results.
ID: 82921
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 310005
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 82922
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099681
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 82923
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 197682
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 82924
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 866910
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 82925
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 308867
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 82926
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1092357
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 82927
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665473
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 82928
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1798370
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 82929
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1798375
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 82930
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 200132
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30