CMS Formulary

Displaying 91091-91100 of 1611142 results.
ID: 91091
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 310671
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91092
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 856792
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91093
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 198297
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91094
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 197506
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91095
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 856706
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91096
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 856429
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91097
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 310670
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91098
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1373483
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 14
Qty Limit Days: 7
ID: 91099
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1373491
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 91100
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 856797
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0