CMS Formulary

Displaying 88841-88850 of 1611142 results.
ID: 88841
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 308973
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88842
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 858824
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88843
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 858828
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88844
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 308976
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88845
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 834348
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88846
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1370767
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 88847
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 310379
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88848
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 310380
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88849
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1313112
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88850
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1370770
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30