CMS Formulary

Displaying 91681-91690 of 1611142 results.
ID: 91681
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 856373
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91682
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 900164
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91683
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 850091
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91684
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 850087
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91685
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 310288
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91686
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 197985
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91687
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 197984
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91688
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 598006
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91689
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 197650
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91690
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091155
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30