CMS Formulary

Displaying 83071-83080 of 1611142 results.
ID: 83071
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 905057
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 168
ID: 83072
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1251334
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83073
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1100070
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 83074
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1487076
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 224
Qty Limit Days: 28
ID: 83075
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1368459
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83076
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 751970
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83077
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 836358
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 312
Qty Limit Days: 30
ID: 83078
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1191250
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83079
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 207373
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83080
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1245268
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28