CMS Formulary

Displaying 83991-84000 of 1611142 results.
ID: 83991
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 897702
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 83992
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 897710
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 83993
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 864706
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 83994
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049611
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 83995
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049618
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 83996
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 884535
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 83997
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 884532
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 83998
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 245136
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 83999
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 245134
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 84000
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 245135
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30