CMS Formulary

Displaying 91-100 of 1611142 results.
ID: 91
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 835721
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1046920
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1008
Qty Limit Days: 90
ID: 93
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 404457
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 404458
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 404459
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1549456
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 97
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1549454
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 98
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 205562
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 763489
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 996559
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0