CMS Formulary

Displaying 93311-93320 of 1611142 results.
ID: 93311
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 979480
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93312
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 248109
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93313
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 314108
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93314
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 311290
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93315
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 854984
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93316
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 854988
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93317
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 854925
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93318
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 857166
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93319
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 857174
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93320
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 904431
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28