CMS Formulary

Displaying 93291-93300 of 1611142 results.
ID: 93291
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 861753
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93292
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 309076
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93293
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 309078
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93294
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 198352
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93295
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 200031
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93296
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 200033
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93297
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 315223
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 30
ID: 93298
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 313161
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 30
ID: 93299
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 313160
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 9
Qty Limit Days: 30
ID: 93300
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 854873
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30