CMS Formulary

Displaying 90811-90820 of 1611142 results.
ID: 90811
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 596843
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 90812
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 308868
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90813
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 403879
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 90814
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 476556
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90815
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 197535
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 270
Qty Limit Days: 30
ID: 90816
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 310295
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 90817
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 310297
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 90818
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 313992
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 90819
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 313993
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 90820
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 310293
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30