CMS Formulary

Displaying 89701-89710 of 1611142 results.
ID: 89701
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 314108
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89702
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 311290
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89703
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 854984
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89704
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 854988
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89705
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 854925
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89706
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 857166
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89707
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 857174
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89708
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 904431
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 89709
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 312087
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89710
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 198334
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0