CMS Formulary

Displaying 88371-88380 of 1611142 results.
ID: 88371
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 905341
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88372
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 905347
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88373
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650143
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88374
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1298910
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 88375
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1298816
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 88376
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1298906
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 270
Qty Limit Days: 30
ID: 88377
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 858613
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88378
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 858616
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88379
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 858747
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88380
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1542997
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28