CMS Formulary

Displaying 91691-91700 of 1611142 results.
ID: 91691
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091170
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 91692
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091185
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 91693
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091210
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 91694
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 808751
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 91695
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 808753
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 91696
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 808744
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 91697
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 861601
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91698
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 861597
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91699
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 615882
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91700
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 284496
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0