CMS Formulary

Displaying 91501-91510 of 1611142 results.
ID: 91501
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1191256
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91502
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 992459
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91503
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 311678
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91504
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1085728
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91505
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1191315
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91506
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 628953
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91507
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 381056
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91508
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 206842
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91509
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 562251
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91510
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 617995
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0