CMS Formulary

Displaying 93361-93370 of 1611142 results.
ID: 93361
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 722137
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93362
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 722126
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93363
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 722131
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93364
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 860715
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 93365
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 860695
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 93366
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 860707
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 93367
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 309058
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93368
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 419849
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93369
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1800499
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93370
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1800500
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0