CMS Formulary

Displaying 90171-90180 of 1611142 results.
ID: 90171
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 883826
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 90172
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 197943
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90173
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 197944
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90174
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659929
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90175
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 2102705
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90176
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058906
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90177
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1872458
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 90178
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049133
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 90179
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049121
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 90180
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1855072
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30