CMS Formulary

Displaying 93231-93240 of 1611142 results.
ID: 93231
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1797113
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 28
ID: 93232
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2399904
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 93233
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1098141
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93234
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1098134
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93235
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 577033
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 93236
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 995624
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93237
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2266506
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 93238
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 857336
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93239
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 857321
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93240
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 857328
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0