CMS Formulary

Displaying 91291-91300 of 1611142 results.
ID: 91291
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 991061
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91292
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 857683
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91293
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000913
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91294
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 198202
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91295
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 857677
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91296
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1245443
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91297
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1245373
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91298
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 309329
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91299
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 314078
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91300
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 197635
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30