CMS Formulary

Displaying 91721-91730 of 1611142 results.
ID: 91721
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1607784
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91722
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 199245
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 91723
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 199246
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 91724
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 199247
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 91725
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 314231
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 91726
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 312961
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 91727
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 198211
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 91728
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 200060
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91729
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 317573
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 91730
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 312440
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30