CMS Formulary

Displaying 89681-89690 of 1611142 results.
ID: 89681
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 309078
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89682
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 198352
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89683
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 200031
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89684
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 200033
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89685
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 315223
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 30
ID: 89686
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 313161
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 30
ID: 89687
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 313160
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 9
Qty Limit Days: 30
ID: 89688
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 854873
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 89689
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 310796
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89690
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 310797
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0