CMS Formulary

Displaying 90341-90350 of 1611142 results.
ID: 90341
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1946844
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 90342
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1946848
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 90343
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 207834
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90344
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1718936
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 90345
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1745114
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90346
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 729234
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90347
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 582971
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90348
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 582976
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90349
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1435117
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 90350
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 351859
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28