CMS Formulary

Displaying 89231-89240 of 1611142 results.
ID: 89231
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 861064
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89232
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 197787
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89233
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 197782
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89234
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 197783
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89235
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 313142
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89236
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 312347
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89237
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 198108
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89238
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1048450
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89239
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1020065
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 89240
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1048445
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0