CMS Formulary

Displaying 89661-89670 of 1611142 results.
ID: 89661
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1673274
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 89662
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1673278
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 89663
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1673280
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 89664
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1925264
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 56
ID: 89665
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049343
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 365
ID: 89666
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 312941
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89667
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 312938
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89668
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 308194
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89669
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 308182
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89670
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 283406
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0