CMS Formulary

Displaying 90071-90080 of 1611142 results.
ID: 90071
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1812013
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90072
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 562806
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 30
ID: 90073
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 825130
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90074
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 260260
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90075
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1370758
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 90076
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 311382
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90077
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 861668
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 90078
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 830795
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90079
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 831359
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90080
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 801957
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0