CMS Formulary

Displaying 90791-90800 of 1611142 results.
ID: 90791
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 476177
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 90792
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 199703
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90793
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1359129
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90794
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 485440
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 90795
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1860157
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 90796
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1860129
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 90797
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1860137
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 90798
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1860148
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 90799
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 835894
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90800
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 835925
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0