CMS Formulary

Displaying 80041-80050 of 1611142 results.
ID: 80041
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 859824
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80042
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 309101
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80043
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 835840
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80044
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 835809
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 5
Qty Limit Days: 28
ID: 80045
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1649988
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80046
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 308189
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80047
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 313797
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80048
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 239191
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80049
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665052
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80050
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665444
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0