CMS Formulary

Displaying 91671-91680 of 1611142 results.
ID: 91671
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 855189
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91672
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 602964
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 91673
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 402131
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 91674
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 349545
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 91675
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 349490
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 91676
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 349553
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 91677
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 349547
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 91678
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 730866
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91679
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 730861
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91680
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 730872
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0