CMS Formulary

Displaying 83961-83970 of 1611142 results.
ID: 83961
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 310404
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83962
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 310405
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83963
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 284191
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83964
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 359697
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83965
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 310169
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83966
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 861657
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83967
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 486148
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83968
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 486152
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83969
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 486146
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83970
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 577057
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30