CMS Formulary

Displaying 88491-88500 of 1611142 results.
ID: 88491
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1797883
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 25
ID: 88492
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 318202
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 88493
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 238600
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88494
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 141859
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 5
Qty Limit Days: 4
ID: 88495
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 310465
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 88496
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1085640
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88497
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1244634
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88498
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1085633
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88499
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1085636
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88500
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 197735
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30