CMS Formulary

Displaying 88521-88530 of 1611142 results.
ID: 88521
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 197574
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 88522
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 197575
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 88523
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 358917
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88524
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 309333
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 88525
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1992273
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88526
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 477451
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 30
ID: 88527
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 855168
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88528
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 198245
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88529
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1540241
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88530
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1597076
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30