CMS Formulary

Displaying 91971-91980 of 1611142 results.
ID: 91971
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 831261
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91972
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 829500
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91973
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 861025
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 765
Qty Limit Days: 30
ID: 91974
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 881341
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91975
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 199690
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91976
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 197417
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91977
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 197418
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91978
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 197419
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91979
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 311207
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91980
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 198239
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0