CMS Formulary

Displaying 91131-91140 of 1611142 results.
ID: 91131
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 966249
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91132
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 892251
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91133
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 892255
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91134
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 966270
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91135
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 349477
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91136
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 198324
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91137
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 198325
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91138
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 198323
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91139
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 855942
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 91140
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 313366
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0