CMS Formulary

Displaying 91221-91230 of 1611142 results.
ID: 91221
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 884532
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 91222
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 245136
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 91223
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 245134
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 91224
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 245135
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 91225
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 197696
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 91226
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1870650
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91227
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 829762
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91228
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1191234
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91229
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1724338
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91230
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1658637
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0