CMS Formulary

Displaying 88951-88960 of 1611142 results.
ID: 88951
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 852920
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88952
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 313096
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88953
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 198224
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88954
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 318179
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88955
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 283535
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88956
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 858778
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 88957
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 198222
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88958
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 198150
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88959
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 96304
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 88960
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 998689
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0