CMS Formulary

Displaying 90821-90830 of 1611142 results.
ID: 90821
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 310294
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 90822
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 314000
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90823
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 310536
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90824
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 310539
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90825
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1299903
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90826
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2000695
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90827
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1299909
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90828
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 197507
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90829
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 197737
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90830
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 310534
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0