CMS Formulary

Displaying 80761-80770 of 1611142 results.
ID: 80761
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 197549
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80762
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 197550
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80763
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 2102717
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 80764
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 2102713
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 80765
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 2102715
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 80766
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 2475840
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 560
Qty Limit Days: 28
ID: 80767
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 2107621
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 80768
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 348506
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80769
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1719862
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80770
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1719803
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0