CMS Formulary

Displaying 91231-91240 of 1611142 results.
ID: 91231
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 307718
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91232
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 307719
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91233
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 831430
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91234
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1807516
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91235
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665210
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91236
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 239209
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91237
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1807518
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91238
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1860139
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91239
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 800192
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91240
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665021
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0