CMS Formulary

Displaying 83951-83960 of 1611142 results.
ID: 83951
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 603203
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 83952
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 603206
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 83953
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 748961
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83954
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 751901
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 84
ID: 83955
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 810096
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 84
ID: 83956
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 749761
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 84
ID: 83957
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 748868
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83958
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 759743
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83959
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 748806
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83960
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 748804
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0