CMS Formulary

Displaying 91981-91990 of 1611142 results.
ID: 91981
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 198238
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91982
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1922720
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91983
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 905341
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91984
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 905347
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91985
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650143
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91986
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1298910
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 91987
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1298816
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 91988
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1298906
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 270
Qty Limit Days: 30
ID: 91989
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 858613
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91990
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 858616
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0