CMS Formulary

Displaying 89261-89270 of 1611142 results.
ID: 89261
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 197980
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89262
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 544455
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89263
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 617322
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89264
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 863599
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89265
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 995241
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89266
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 309686
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89267
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 312055
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 900
Qty Limit Days: 30
ID: 89268
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1085745
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89269
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 992432
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89270
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000054
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0