CMS Formulary

Displaying 90401-90410 of 1611142 results.
ID: 90401
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 836636
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90402
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 836634
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90403
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1597099
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 365
ID: 90404
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1597103
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 365
ID: 90405
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1292443
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90406
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 804186
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90407
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1292459
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 365
ID: 90408
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1658106
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90409
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1658102
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90410
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 798451
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0