CMS Formulary

Displaying 80891-80900 of 1611142 results.
ID: 80891
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 198211
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 80892
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 200060
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80893
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 317573
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 80894
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 312440
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 80895
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 312441
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 80896
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 199123
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80897
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 197956
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80898
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 197958
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80899
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 200064
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 80900
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 199224
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0