CMS Formulary

Displaying 88291-88300 of 1611142 results.
ID: 88291
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 905225
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88292
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 905395
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88293
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 198371
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88294
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 197817
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 88295
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 197818
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 88296
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 197889
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88297
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 855172
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88298
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 242679
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88299
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 309313
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 600
Qty Limit Days: 30
ID: 88300
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 351285
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0