CMS Formulary

Displaying 91891-91900 of 1611142 results.
ID: 91891
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 996571
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 91892
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 996561
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 91893
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 854916
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91894
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 854919
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91895
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 854908
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91896
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 201708
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91897
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 248420
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91898
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 351172
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91899
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 199422
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91900
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 200082
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0