CMS Formulary

Displaying 80881-80890 of 1611142 results.
ID: 80881
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1605086
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80882
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 904419
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 80883
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 866436
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80884
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 855633
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80885
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 1607784
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80886
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 199245
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 80887
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 199246
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 80888
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 199247
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 80889
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 314231
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 80890
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 312961
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30