CMS Formulary

Displaying 93651-93660 of 1611142 results.
ID: 93651
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 855642
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 28
ID: 93652
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 312504
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93653
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 313291
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93654
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1245919
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93655
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1242786
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93656
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 200329
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93657
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 864681
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93658
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 307731
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93659
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 864675
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93660
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 835726
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0