CMS Formulary

Displaying 89801-89810 of 1611142 results.
ID: 89801
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 388311
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89802
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 200133
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89803
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 200131
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89804
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 861237
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 89805
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 861221
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 89806
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 861223
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 89807
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 861225
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 89808
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 861227
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 89809
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 861232
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 89810
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1367436
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28