CMS Formulary

Displaying 83581-83590 of 1611142 results.
ID: 83581
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1098666
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83582
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1098678
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83583
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 904467
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83584
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 904475
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83585
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1490065
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83586
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 199058
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83587
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 596843
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 83588
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 308868
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83589
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 403879
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 83590
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 476556
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0