CMS Formulary

Displaying 88651-88660 of 1611142 results.
ID: 88651
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 312439
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88652
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 198103
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88653
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 250820
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 88654
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 858751
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88655
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 858733
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88656
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 848943
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88657
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801279
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88658
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 207362
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88659
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 403840
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88660
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 207364
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0