CMS Formulary

Displaying 88681-88690 of 1611142 results.
ID: 88681
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 308460
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88682
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 749783
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88683
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 248656
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88684
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 749780
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88685
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 204844
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88686
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 198372
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88687
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 198369
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88688
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 198370
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88689
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1242819
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 56
ID: 88690
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1242815
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 56