CMS Formulary

Displaying 93861-93870 of 1611142 results.
ID: 93861
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2199304
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93862
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2199308
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93863
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2199312
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93864
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2199316
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93865
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 206883
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93866
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2473107
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93867
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 206902
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93868
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 483450
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 93869
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 483438
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 93870
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 483440
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30