CMS Formulary

Displaying 80421-80430 of 1611142 results.
ID: 80421
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1805422
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 80422
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1602594
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 80423
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1858971
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80424
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 751620
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80425
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 751623
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80426
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 751616
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80427
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 827075
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80428
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 833151
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80429
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 833139
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 80430
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 833143
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30