CMS Formulary

Displaying 80731-80740 of 1611142 results.
ID: 80731
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 991044
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80732
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 991188
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80733
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 584414
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 80734
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 857297
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80735
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 857301
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80736
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 857305
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80737
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1596780
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 80738
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 855292
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80739
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 855306
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80740
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 855316
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0