CMS Formulary

Displaying 91541-91550 of 1611142 results.
ID: 91541
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 403850
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91542
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 810090
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91543
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 403851
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91544
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 810083
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91545
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 403852
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91546
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 730988
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91547
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 349556
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 91548
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 240741
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91549
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 309322
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91550
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 476576
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0