CMS Formulary

Displaying 91751-91760 of 1611142 results.
ID: 91751
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 312744
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 91752
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 616487
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 91753
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 312962
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 91754
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 349332
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91755
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 351250
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91756
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 856834
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91757
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 856845
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91758
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 856853
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91759
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 856762
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91760
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 856773
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0