CMS Formulary

Displaying 89901-89910 of 1611142 results.
ID: 89901
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 197886
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89902
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 197887
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89903
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 314203
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89904
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 312749
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89905
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 199353
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89906
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 199351
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89907
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 199352
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89908
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 198189
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89909
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 261962
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 89910
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 199147
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0