CMS Formulary

Displaying 89171-89180 of 1611142 results.
ID: 89171
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 404449
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 89172
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 700418
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 89173
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 404450
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 89174
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1242233
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 89175
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 616116
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 89176
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 616114
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 89177
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 643714
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 89178
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1429367
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 89179
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 643722
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 89180
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1369724
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28