CMS Formulary

Displaying 88631-88640 of 1611142 results.
ID: 88631
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 197739
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88632
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 861156
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88633
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 896758
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88634
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 896762
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88635
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 199369
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88636
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 861164
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88637
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 861171
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88638
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 645037
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 88639
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000064
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88640
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 197987
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0