CMS Formulary

Displaying 91761-91770 of 1611142 results.
ID: 91761
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 429503
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91762
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 310798
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91763
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 197770
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91764
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 309362
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91765
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 198223
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91766
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 856364
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91767
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 863636
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91768
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 863619
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91769
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 863628
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91770
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 314080
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0