CMS Formulary

Displaying 88931-88940 of 1611142 results.
ID: 88931
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1010878
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88932
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1085741
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88933
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1191302
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88934
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 310152
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 88935
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1370763
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 118
Qty Limit Days: 30
ID: 88936
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 2180999
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88937
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1716268
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88938
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1921598
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88939
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806890
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88940
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 2184126
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30