CMS Formulary

Displaying 89161-89170 of 1611142 results.
ID: 89161
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 2274816
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 89162
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 2274814
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 89163
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 2044355
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 89164
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 2044357
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 89165
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 2044969
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 89166
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 2044967
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 89167
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 2044971
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 89168
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1649961
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 30
ID: 89169
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1550946
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 89170
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 213360
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30