CMS Formulary

Displaying 91241-91250 of 1611142 results.
ID: 91241
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 309090
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91242
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 309092
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91243
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665005
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91244
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 311683
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91245
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 727575
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91246
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1040012
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91247
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1040016
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91248
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653470
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91249
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1086776
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 91250
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1086780
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30