CMS Formulary

Displaying 89461-89470 of 1611142 results.
ID: 89461
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1190572
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89462
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 686418
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89463
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 476345
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 89464
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 476349
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 89465
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 476350
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 89466
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 476351
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 89467
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 835829
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89468
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 860975
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 89469
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 860981
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 89470
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 312136
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0