CMS Formulary

Displaying 90851-90860 of 1611142 results.
ID: 90851
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 351133
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90852
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 313979
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90853
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 834127
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90854
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 141935
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90855
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 849385
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90856
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 861848
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90857
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 859835
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90858
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 905273
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90859
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099687
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90860
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 312036
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0