CMS Formulary

Displaying 80061-80070 of 1611142 results.
ID: 80061
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 311033
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28
ID: 80062
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 311027
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28
ID: 80063
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 213442
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28
ID: 80064
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1860172
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 15
Qty Limit Days: 28
ID: 80065
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 2206092
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 80066
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 2206099
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 80067
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049380
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 80068
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1986354
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28
ID: 80069
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1986356
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 80070
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 2205454
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28