CMS Formulary

Displaying 93441-93450 of 1611142 results.
ID: 93441
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 317174
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 93442
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 312745
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 93443
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 616483
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 93444
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 312743
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 93445
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 637173
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93446
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 312840
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 93447
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 314209
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 93448
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 199206
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 93449
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 197805
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93450
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 197806
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0