CMS Formulary

Displaying 88551-88560 of 1611142 results.
ID: 88551
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 2053458
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88552
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 199592
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 88553
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 483090
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88554
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 476399
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88555
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 476515
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88556
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 805464
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 88557
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659927
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88558
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 2056748
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 25
ID: 88559
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 2046585
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 88560
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 403878
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30