CMS Formulary

Displaying 89071-89080 of 1611142 results.
ID: 89071
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 197499
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89072
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 197500
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89073
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 198105
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89074
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 198104
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89075
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1662285
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89076
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 205329
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 89077
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 205330
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 89078
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 205331
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 89079
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 999967
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89080
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 999996
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0