CMS Formulary

Displaying 91151-91160 of 1611142 results.
ID: 91151
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000076
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91152
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1298088
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 91153
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1298091
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 91154
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 242892
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 91155
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1149632
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 91156
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 242891
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 91157
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 248478
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 91158
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 198296
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91159
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000097
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91160
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 830865
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0