CMS Formulary

Displaying 91391-91400 of 1611142 results.
ID: 91391
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 311386
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91392
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 311385
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91393
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 314075
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91394
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 310812
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91395
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 861427
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91396
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 197653
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 91397
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 991086
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91398
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 314006
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 91399
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 315107
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 91400
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 310489
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30