CMS Formulary

Displaying 90191-90200 of 1611142 results.
ID: 90191
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1866047
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90192
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099026
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90193
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099269
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90194
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1006065
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90195
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1020155
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 84
ID: 90196
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1720616
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90197
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1369737
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90198
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1722676
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90199
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1369770
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90200
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1941470
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0