CMS Formulary

Displaying 80171-80180 of 1611142 results.
ID: 80171
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 993462
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80172
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047868
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 80173
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 834350
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80174
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801299
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80175
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 832731
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80176
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801295
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80177
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123111
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 13
Qty Limit Days: 30
ID: 80178
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 198071
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80179
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 197541
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 80180
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 753478
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0