CMS Formulary

Displaying 91931-91940 of 1611142 results.
ID: 91931
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 199193
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91932
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 198382
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91933
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 997226
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 91934
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 997220
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 91935
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 349201
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91936
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 200034
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 91937
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 312078
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 91938
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 314154
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 91939
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 283639
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 91940
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 200284
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0