CMS Formulary

Displaying 90011-90020 of 1611142 results.
ID: 90011
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 310434
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 90012
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 403966
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90013
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 403967
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90014
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1358776
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90015
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 309367
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90016
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 198014
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90017
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 311753
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90018
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1299897
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90019
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 197891
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90020
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 197892
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0