CMS Formulary

Displaying 90801-90810 of 1611142 results.
ID: 90801
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 241834
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90802
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1368954
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90803
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 349094
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90804
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 351109
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90805
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1098666
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90806
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1098678
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90807
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 904467
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90808
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 904475
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90809
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1490065
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90810
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 199058
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0