CMS Formulary

Displaying 91561-91570 of 1611142 results.
ID: 91561
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 198322
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91562
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 308962
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91563
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 849395
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91564
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 991039
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91565
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 991194
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91566
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 991336
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91567
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 991044
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91568
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 991188
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91569
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 584414
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 91570
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 857297
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0