CMS Formulary

Displaying 88431-88440 of 1611142 results.
ID: 88431
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 312750
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88432
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 312748
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88433
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 312079
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 88434
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 208185
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88435
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 577127
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 88436
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 404013
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88437
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 404011
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88438
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 597990
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88439
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 597984
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88440
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 597993
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0