CMS Formulary

Displaying 82951-82960 of 1611142 results.
ID: 82951
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 2102705
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 82952
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058906
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 82953
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1872458
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 82954
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049133
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 82955
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049121
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 82956
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1855072
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 82957
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1986331
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 82958
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1918230
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 82959
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 2054269
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 82960
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 2362178
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30