CMS Formulary

Displaying 91771-91780 of 1611142 results.
ID: 91771
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1190655
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91772
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 545236
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91773
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1724340
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91774
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1244616
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 91775
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 312075
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91776
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 308345
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91777
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 197636
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 91778
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 260243
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91779
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 312641
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91780
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1312625
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0