CMS Formulary

Displaying 80571-80580 of 1611142 results.
ID: 80571
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1431286
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 80572
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 897612
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80573
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 897618
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80574
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 897624
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80575
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 897630
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80576
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 312025
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80577
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 198041
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80578
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 582926
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80579
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1597123
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 80580
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1597129
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30