CMS Formulary

Displaying 89021-89030 of 1611142 results.
ID: 89021
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 861360
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89022
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1734683
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89023
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 2396905
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89024
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1492746
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89025
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 727542
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89026
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 727545
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89027
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1605455
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89028
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1649946
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89029
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1649964
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89030
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 993456
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 180