CMS Formulary

Displaying 82931-82940 of 1611142 results.
ID: 82931
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 199149
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 82932
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 199150
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 82933
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 311915
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 82934
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1725064
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 82935
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 2001439
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 82936
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1437713
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 82937
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1918242
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 82938
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1862595
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 82939
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1921589
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 82940
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1862590
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30