CMS Formulary

Displaying 83851-83860 of 1611142 results.
ID: 83851
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 856720
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83852
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 197505
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83853
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 198286
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83854
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1298857
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83855
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 197464
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 83856
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 856840
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83857
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 197436
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83858
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 197437
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83859
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 197438
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83860
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 197439
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0