CMS Formulary

Displaying 90721-90730 of 1611142 results.
ID: 90721
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 603103
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90722
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 106346
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 220
Qty Limit Days: 30
ID: 90723
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1098649
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90724
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1098670
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90725
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1098674
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90726
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923422
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90727
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923426
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90728
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923424
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90729
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 904589
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90730
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 309043
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0