CMS Formulary

Displaying 90671-90680 of 1611142 results.
ID: 90671
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1365866
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90672
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1656351
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90673
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1873991
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 90674
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1873993
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 42
Qty Limit Days: 28
ID: 90675
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1873995
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 63
Qty Limit Days: 28
ID: 90676
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1421456
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90677
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923054
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 49
Qty Limit Days: 28
ID: 90678
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801840
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 90679
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923056
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 70
Qty Limit Days: 28
ID: 90680
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923058
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 28