CMS Formulary

Displaying 80331-80340 of 1611142 results.
ID: 80331
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 226552
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 80332
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 748878
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80333
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1111641
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 80334
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1487361
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 80335
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 351137
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 80336
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 351136
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 80337
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 199689
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80338
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 603208
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 80339
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 603203
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 80340
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 603206
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30