CMS Formulary

Displaying 93131-93140 of 1611142 results.
ID: 93131
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 483427
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93132
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 483425
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93133
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 309140
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93134
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 197518
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93135
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 284215
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93136
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 544840
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93137
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 313165
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 93138
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 865129
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93139
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1807513
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93140
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 312447
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0