CMS Formulary

Displaying 91101-91110 of 1611142 results.
ID: 91101
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 866491
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91102
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 197963
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91103
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 197508
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91104
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 197318
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91105
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 856825
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91106
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 313354
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91107
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 198274
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91108
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 198275
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91109
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 198270
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91110
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 197960
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0