CMS Formulary

Displaying 90781-90790 of 1611142 results.
ID: 90781
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1299917
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90782
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 995218
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90783
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1299896
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90784
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 866090
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90785
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 643066
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90786
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1652084
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90787
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1006801
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 90788
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 996921
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 90789
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 721773
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 90790
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 476179
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30