CMS Formulary

Displaying 98891-98900 of 1611142 results.
ID: 98891
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 402695
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 98892
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 351249
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 98893
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 858625
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 98894
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 855182
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 98895
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 855189
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 98896
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 602964
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 98897
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 402131
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 98898
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 349545
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 98899
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 349490
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 98900
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 349553
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30