CMS Formulary

Displaying 88721-88730 of 1611142 results.
ID: 88721
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 477391
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88722
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 197877
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 88723
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1010739
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88724
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 391937
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88725
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 197305
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88726
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 313786
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88727
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 212787
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88728
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1312408
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 84
Qty Limit Days: 28
ID: 88729
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1439894
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 88730
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1439896
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30