CMS Formulary

Displaying 89621-89630 of 1611142 results.
ID: 89621
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1098141
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89622
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1098134
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89623
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 577033
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 89624
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 995624
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89625
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 2266506
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 89626
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 857336
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89627
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 857321
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89628
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 857328
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89629
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 857340
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89630
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 259081
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30