CMS Formulary

Displaying 93071-93080 of 1611142 results.
ID: 93071
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 886671
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93072
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 686400
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93073
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1190572
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93074
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 686418
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93075
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 476345
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 93076
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 476349
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 93077
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 476350
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 93078
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 476351
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 93079
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 835829
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93080
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 860975
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30