CMS Formulary

Displaying 83441-83450 of 1611142 results.
ID: 83441
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1919094
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 224
Qty Limit Days: 28
ID: 83442
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 2169314
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 83443
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 2169322
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 83444
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 2362240
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 83445
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 2169320
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 83446
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 2362244
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 83447
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1365866
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83448
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1656351
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83449
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1873991
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 83450
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1873993
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 42
Qty Limit Days: 28