CMS Formulary

Displaying 91861-91870 of 1611142 results.
ID: 91861
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 242800
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91862
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1721315
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91863
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1721314
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91864
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1361574
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91865
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 200193
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 30
ID: 91866
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 200194
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 30
ID: 91867
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 616539
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 91868
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 616541
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 91869
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 317094
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91870
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 349435
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0