CMS Formulary

Displaying 80601-80610 of 1611142 results.
ID: 80601
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 197363
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80602
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 197364
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80603
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 197383
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80604
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 197382
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80605
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 805515
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80606
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 603378
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80607
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1190225
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 30
ID: 80608
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 580261
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 80609
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 836368
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 25
Qty Limit Days: 28
ID: 80610
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1552004
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30