CMS Formulary

Displaying 80371-80380 of 1611142 results.
ID: 80371
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049214
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 80372
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091497
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 80373
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091392
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 80374
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091145
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 80375
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091225
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 80376
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806181
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 80377
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806197
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 80378
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 897696
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 80379
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 897702
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 80380
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 897710
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30