CMS Formulary

Displaying 91211-91220 of 1611142 results.
ID: 91211
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091225
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 91212
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806181
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 91213
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806197
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 91214
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 897696
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 91215
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 897702
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 91216
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 897710
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 91217
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 864706
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 91218
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049611
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 91219
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049618
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 91220
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 884535
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30