CMS Formulary

Displaying 91601-91610 of 1611142 results.
ID: 91601
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2102715
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 91602
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2475840
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 560
Qty Limit Days: 28
ID: 91603
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2107621
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 91604
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 348506
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91605
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1719862
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91606
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1719803
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91607
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 866103
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 91608
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 672567
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 91609
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 672569
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 91610
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 672571
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30