CMS Formulary

Displaying 88451-88460 of 1611142 results.
ID: 88451
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 198430
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88452
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 252478
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88453
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 103968
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88454
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 252479
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88455
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1010600
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 88456
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1307056
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 88457
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1010604
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 88458
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 198182
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88459
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 351223
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 88460
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 198070
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0