CMS Formulary

Displaying 83471-83480 of 1611142 results.
ID: 83471
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 285018
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28
ID: 83472
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 855178
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83473
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 866094
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83474
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 866083
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83475
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 211817
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83476
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801283
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83477
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 857461
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83478
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 978006
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83479
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 834022
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 20
Qty Limit Days: 30
ID: 83480
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 833217
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0