CMS Formulary

Displaying 80641-80650 of 1611142 results.
ID: 80641
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 885219
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80642
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 885213
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80643
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 197426
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 80644
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 859315
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 80645
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049635
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 80646
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 198086
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80647
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 199167
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80648
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 199164
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80649
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 763181
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80650
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 763179
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0