CMS Formulary

Displaying 83361-83370 of 1611142 results.
ID: 83361
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047623
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 83362
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 2463737
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 83363
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 2463733
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 83364
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 2105856
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 83365
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 2168548
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 83366
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058932
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 83367
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1148506
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 83368
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1148502
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 83369
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 2168540
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 83370
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 207088
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0