CMS Formulary

Displaying 90581-90590 of 1611142 results.
ID: 90581
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047602
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 90582
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047608
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 90583
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047614
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 90584
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047596
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 90585
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047623
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 90586
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2463737
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 90587
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2463733
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 90588
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2105856
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 90589
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2168548
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 90590
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058932
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30