CMS Formulary

Displaying 88581-88590 of 1611142 results.
ID: 88581
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 310362
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88582
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 197623
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88583
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 2055650
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 88584
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099808
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88585
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1484296
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88586
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1190919
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88587
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1244205
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88588
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 830470
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88589
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1300310
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88590
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1300206
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0