CMS Formulary

Displaying 91651-91660 of 1611142 results.
ID: 91651
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 197593
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91652
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 199168
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91653
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 312357
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91654
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 312362
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91655
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2106334
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91656
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1661220
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91657
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1809580
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91658
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 854876
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 91659
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 283672
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 91660
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 200371
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30