CMS Formulary

Displaying 93021-93030 of 1611142 results.
ID: 93021
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 831325
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93022
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 831349
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93023
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801298
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93024
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801294
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93025
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1044591
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 93026
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 311192
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93027
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 311197
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93028
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 311196
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93029
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 854868
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 93030
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2001564
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30