CMS Formulary

Displaying 88161-88170 of 1611142 results.
ID: 88161
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1724340
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88162
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1244616
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 88163
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 312075
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88164
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 308345
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88165
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 197636
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 88166
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 260243
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88167
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 312641
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88168
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1312625
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88169
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1365660
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88170
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1365847
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0