CMS Formulary

Displaying 93501-93510 of 1611142 results.
ID: 93501
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 197452
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93502
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 197453
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93503
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 309110
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93504
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 309113
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93505
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 200345
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 93506
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 197903
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93507
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 197904
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93508
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 197905
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93509
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 311353
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93510
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 311354
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0