CMS Formulary

Displaying 91491-91500 of 1611142 results.
ID: 91491
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1047041
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91492
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1727569
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91493
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2171002
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91494
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 403920
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91495
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 312068
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91496
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 314152
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91497
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 312071
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91498
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 859867
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91499
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 992481
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91500
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 198159
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0