CMS Formulary

Displaying 90431-90440 of 1611142 results.
ID: 90431
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 762852
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90432
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 762859
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90433
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 762868
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90434
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 762897
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90435
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1009341
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 25
ID: 90436
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1595462
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90437
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1595473
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90438
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1595478
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90439
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1595292
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90440
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1995479
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0