CMS Formulary

Displaying 93751-93760 of 1611142 results.
ID: 93751
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 198032
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93752
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 309307
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93753
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790684
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93754
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 197854
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93755
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 310003
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93756
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 310004
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93757
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 310005
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93758
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099681
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93759
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 197682
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93760
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 866910
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0