CMS Formulary

Displaying 90841-90850 of 1611142 results.
ID: 90841
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 856519
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90842
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 856578
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90843
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 856556
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90844
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 242831
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90845
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 239239
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90846
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 856605
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90847
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 903857
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90848
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 856656
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90849
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 856660
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90850
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 856652
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0