CMS Formulary

Displaying 93801-93810 of 1611142 results.
ID: 93801
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1944376
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 93802
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1921081
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 93803
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1866047
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93804
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099026
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93805
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099269
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93806
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1006065
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93807
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1020155
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 84
ID: 93808
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1720616
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93809
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1369737
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93810
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1722676
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0