CMS Formulary

Displaying 93421-93430 of 1611142 results.
ID: 93421
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 861232
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 93422
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1367436
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 93423
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 352210
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93424
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 198175
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93425
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1361615
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93426
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1361226
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93427
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 861363
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93428
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 861365
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93429
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 861356
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93430
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1737244
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0