CMS Formulary

Displaying 91781-91790 of 1611142 results.
ID: 91781
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1365660
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91782
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1365847
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91783
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1365850
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91784
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1928954
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 91785
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1090641
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91786
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 905222
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91787
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 197855
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91788
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 197856
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91789
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 897683
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91790
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 314184
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0