CMS Formulary

Displaying 93811-93820 of 1611142 results.
ID: 93811
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1369770
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93812
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1941470
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93813
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1941476
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93814
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1941473
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93815
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 197698
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93816
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 856783
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93817
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1607796
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93818
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1607792
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93819
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1992873
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 25
ID: 93820
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2119706
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 25