CMS Formulary

Displaying 90691-90700 of 1611142 results.
ID: 90691
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1251596
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90692
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 207035
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90693
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 261101
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90694
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 847232
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 90695
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 285018
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28
ID: 90696
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 855178
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90697
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 866094
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90698
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 866083
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90699
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 211817
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90700
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801283
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0