CMS Formulary

Displaying 93691-93700 of 1611142 results.
ID: 93691
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 831359
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93692
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 801957
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93693
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 801961
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93694
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 801966
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93695
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 245723
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93696
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 830861
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93697
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 830845
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93698
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 830837
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93699
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 830801
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93700
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 352257
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 540
Qty Limit Days: 30