CMS Formulary

Displaying 93011-93020 of 1611142 results.
ID: 93011
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1939335
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 93012
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1999673
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93013
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 315183
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93014
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 831226
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93015
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 831255
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93016
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 831309
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93017
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 831338
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93018
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 831196
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93019
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 831248
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93020
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 831300
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0