CMS Formulary

Displaying 80391-80400 of 1611142 results.
ID: 80391
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 829762
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80392
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1191234
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80393
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1724338
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80394
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1658637
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80395
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 307718
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80396
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 307719
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80397
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 831430
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80398
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1807516
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80399
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665210
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80400
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 239209
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0