CMS Formulary

Displaying 93081-93090 of 1611142 results.
ID: 93081
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 860981
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 93082
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 312136
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93083
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 312137
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93084
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1299911
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93085
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 855861
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93086
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 197890
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93087
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 855873
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93088
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2360548
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93089
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 308989
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93090
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 308988
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0