CMS Formulary

Displaying 88171-88180 of 1611142 results.
ID: 88171
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1365850
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88172
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1928954
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 88173
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1090641
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88174
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 905222
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88175
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 197855
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88176
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 197856
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88177
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 897683
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88178
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 314184
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88179
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 311918
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 9
Qty Limit Days: 30
ID: 88180
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 314135
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 9
Qty Limit Days: 30