CMS Formulary

Displaying 91791-91800 of 1611142 results.
ID: 91791
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 311918
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 9
Qty Limit Days: 30
ID: 91792
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 314135
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 9
Qty Limit Days: 30
ID: 91793
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 310537
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91794
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 897722
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91795
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 197942
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91796
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 197941
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91797
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 861007
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 91798
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 861010
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 91799
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 861004
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 75
Qty Limit Days: 30
ID: 91800
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 861731
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30