CMS Formulary

Displaying 83041-83050 of 1611142 results.
ID: 83041
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 2382991
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 28
ID: 83042
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 2382993
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 83043
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 2272630
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83044
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 2272622
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83045
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 2272636
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83046
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 2272624
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83047
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 2282414
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 83048
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 2283236
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 83049
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 848333
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 84
ID: 83050
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 848343
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 84