CMS Formulary

Displaying 91731-91740 of 1611142 results.
ID: 91731
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 312441
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 91732
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 199123
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91733
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 197956
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91734
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 197958
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91735
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 200064
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91736
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 199224
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91737
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 313190
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91738
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 198377
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91739
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 198378
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91740
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1483744
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0