CMS Formulary

Displaying 89711-89720 of 1611142 results.
ID: 89711
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 198335
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89712
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 433798
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 89713
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 433800
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 89714
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 433799
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 89715
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 433801
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 89716
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 979468
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89717
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 979464
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89718
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 979471
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89719
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 198188
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89720
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 313134
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0