CMS Formulary

Displaying 89631-89640 of 1611142 results.
ID: 89631
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 835603
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 89632
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 283536
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89633
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 199387
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 480
Qty Limit Days: 30
ID: 89634
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 312085
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89635
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 308429
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89636
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 283523
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 2160
Qty Limit Days: 30
ID: 89637
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 197745
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89638
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 197746
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89639
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 198358
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89640
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099569
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0