CMS Formulary

Displaying 91471-91480 of 1611142 results.
ID: 91471
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1862692
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 91472
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1037181
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 91473
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1037049
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 91474
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 991082
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91475
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 702519
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91476
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 314182
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91477
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 885219
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91478
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 885213
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91479
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 197426
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 91480
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 859315
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30