CMS Formulary

Displaying 91941-91950 of 1611142 results.
ID: 91941
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 312076
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 91942
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 351108
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 91943
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 349251
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91944
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 905041
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 91945
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 905092
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 91946
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 905100
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 91947
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 153822
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91948
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 153823
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91949
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 639537
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91950
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 578325
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0