CMS Formulary

Displaying 90551-90560 of 1611142 results.
ID: 90551
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058922
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 90552
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2103175
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 90553
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2103179
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 90554
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 810075
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90555
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 810079
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90556
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2284108
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 90557
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2057205
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90558
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2057216
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90559
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2057212
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90560
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2057219
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0