CMS Formulary

Displaying 91571-91580 of 1611142 results.
ID: 91571
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 857301
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91572
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 857305
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91573
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1596780
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 91574
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 855292
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91575
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 855306
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91576
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 855316
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91577
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 855322
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91578
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 855328
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91579
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 855336
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91580
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 855342
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0