CMS Formulary

Displaying 83381-83390 of 1611142 results.
ID: 83381
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1747567
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 83382
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1747580
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83383
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1921017
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83384
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1921010
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83385
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1921468
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83386
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 152971
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83387
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 2166143
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83388
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 2196900
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83389
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1873087
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83390
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1940709
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 84
Qty Limit Days: 28