CMS Formulary

Displaying 91011-91020 of 1611142 results.
ID: 91011
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 832731
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91012
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801295
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91013
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123111
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 13
Qty Limit Days: 30
ID: 91014
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 198071
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91015
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 197541
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 91016
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 753478
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91017
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 753479
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91018
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1428933
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91019
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091828
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91020
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 351173
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0