CMS Formulary

Displaying 91921-91930 of 1611142 results.
ID: 91921
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 197311
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91922
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 197313
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91923
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 313566
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91924
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 485434
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91925
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 485436
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91926
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 859424
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 91927
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 859747
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 91928
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 859751
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 91929
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 859419
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 91930
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 199192
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0