CMS Formulary

Displaying 90271-90280 of 1611142 results.
ID: 90271
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 2282414
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 90272
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 2283236
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 90273
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 848333
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 84
ID: 90274
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 848343
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 84
ID: 90275
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665906
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 90276
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665900
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 90277
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801322
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 7
Qty Limit Days: 28
ID: 90278
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 2262446
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 90279
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123034
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90280
Formulary ID: 00021031
Formulary Version: 14
Contract Year: 2021
RXCUI: 2274390
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30