CMS Formulary

Displaying 91801-91810 of 1611142 results.
ID: 91801
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 562524
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91802
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1652673
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91803
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1649429
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91804
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650142
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91805
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650444
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91806
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 406524
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91807
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 434018
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91808
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 799048
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91809
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 353538
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91810
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 897666
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0