CMS Formulary

Displaying 93661-93670 of 1611142 results.
ID: 93661
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 349373
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93662
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 857216
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93663
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 857224
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93664
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 197572
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93665
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 314266
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 30
ID: 93666
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 749784
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93667
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 644088
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 93668
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1603861
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 84
ID: 93669
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1251336
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93670
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 749157
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0