CMS Formulary

Displaying 80271-80280 of 1611142 results.
ID: 80271
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 198274
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80272
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 198275
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80273
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 198270
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80274
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 197960
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80275
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 198285
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80276
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 856422
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80277
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 199903
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80278
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 998671
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 80279
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 998675
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 80280
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 998679
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28