CMS Formulary

Displaying 88021-88030 of 1611142 results.
ID: 88021
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091133
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 900
Qty Limit Days: 30
ID: 88022
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 863664
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88023
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1483329
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 88024
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1006122
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88025
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 2055676
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 88026
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 2055672
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 88027
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 314111
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88028
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 858798
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 88029
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 197738
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88030
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 311725
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0