CMS Formulary

Displaying 88001-88010 of 1611142 results.
ID: 88001
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 993557
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88002
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 996097
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88003
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 996615
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 88004
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 996594
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 88005
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 996603
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 88006
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 996609
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 88007
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1540356
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88008
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 992475
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88009
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 995258
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88010
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1297753
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0