CMS Formulary

Displaying 81-90 of 1611142 results.
ID: 81
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1292443
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 82
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 804186
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1292459
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 365
ID: 84
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1658106
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 85
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1658102
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 86
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 798451
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 87
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 830263
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1658150
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2055815
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1441740
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0