CMS Formulary

Displaying 91511-91520 of 1611142 results.
ID: 91511
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 198316
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91512
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 359296
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91513
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 308212
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91514
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 403810
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 91515
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 403811
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 91516
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806195
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 91517
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806179
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 91518
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806183
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 91519
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 308191
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91520
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 199119
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0