CMS Formulary

Displaying 91171-91180 of 1611142 results.
ID: 91171
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 351137
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 91172
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 351136
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 91173
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 199689
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91174
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 603208
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 91175
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 603203
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 91176
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 603206
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 91177
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 748961
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91178
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 751901
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 84
ID: 91179
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 810096
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 84
ID: 91180
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 749761
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 84