CMS Formulary

Displaying 91991-92000 of 1611142 results.
ID: 91991
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 858747
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91992
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1542997
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 91993
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1432969
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 91994
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 904880
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 91995
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 891881
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 91996
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 891888
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 91997
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 891893
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 91998
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 891874
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 91999
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 892646
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 92000
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 848726
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30