CMS Formulary

Displaying 88691-88700 of 1611142 results.
ID: 88691
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 616749
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88692
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 728231
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88693
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 2391560
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88694
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1657212
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88695
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1735537
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88696
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 992403
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88697
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1735496
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88698
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1147228
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 88699
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 2197873
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 88700
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 2197877
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30