CMS Formulary

Displaying 93061-93070 of 1611142 results.
ID: 93061
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1536490
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93062
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 310878
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93063
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049696
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 93064
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 311982
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93065
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 104884
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93066
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 861430
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93067
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 197939
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93068
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 197940
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93069
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 886662
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93070
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 886666
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0