CMS Formulary

Displaying 91371-91380 of 1611142 results.
ID: 91371
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 857560
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91372
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 898362
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91373
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 312529
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91374
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 977880
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91375
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047882
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91376
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 310190
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91377
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 310191
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91378
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 261178
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 91379
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 313941
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 91380
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 198300
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0