CMS Formulary

Displaying 88741-88750 of 1611142 results.
ID: 88741
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 706831
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 88742
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 706827
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 88743
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 706829
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 88744
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 706825
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 88745
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 858074
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 28
ID: 88746
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 858051
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 28
ID: 88747
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 858057
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 28
ID: 88748
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 858055
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 88749
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 858053
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 88750
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 2059017
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30