CMS Formulary

Displaying 93491-93500 of 1611142 results.
ID: 93491
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 307650
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93492
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 616402
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 93493
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 309097
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93494
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 309098
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93495
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 835572
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93496
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 835591
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93497
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 835577
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93498
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 312940
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93499
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 309080
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93500
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 309081
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0