CMS Formulary

Displaying 90871-90880 of 1611142 results.
ID: 90871
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 197604
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90872
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 197606
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90873
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 198089
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90874
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 198083
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90875
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 314055
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90876
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1655960
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90877
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 859824
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90878
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 309101
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90879
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 835840
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 90880
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 835809
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 5
Qty Limit Days: 28