CMS Formulary

Displaying 90711-90720 of 1611142 results.
ID: 90711
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 197603
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90712
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 198107
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90713
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 904458
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90714
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 197380
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90715
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 198045
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90716
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 317136
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90717
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 198046
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90718
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 198047
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90719
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 312059
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90720
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 866018
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0