CMS Formulary

Displaying 83691-83700 of 1611142 results.
ID: 83691
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 2200658
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 83692
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 2200650
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 83693
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653204
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 83694
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 351926
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28
ID: 83695
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 849851
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83696
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 847247
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83697
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 847348
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83698
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 847245
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83699
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 197590
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 83700
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 197591
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30