CMS Formulary

Displaying 90601-90610 of 1611142 results.
ID: 90601
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 847745
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 90602
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1872980
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90603
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1747577
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 90604
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1747579
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 90605
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1747567
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 90606
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1747580
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90607
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1921017
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90608
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1921010
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90609
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1921468
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90610
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 152971
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0