CMS Formulary

Displaying 83191-83200 of 1611142 results.
ID: 83191
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 835721
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83192
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1046920
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1008
Qty Limit Days: 90
ID: 83193
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 404457
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83194
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 404458
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83195
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 404459
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83196
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1549456
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83197
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1549454
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83198
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 205562
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83199
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 763489
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83200
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 996559
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0