CMS Formulary

Displaying 93971-93980 of 1611142 results.
ID: 93971
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364447
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 93972
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1145932
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93973
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1799230
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93974
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1925255
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93975
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1925257
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93976
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1598989
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93977
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1601660
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93978
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1992428
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93979
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 213282
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93980
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 213283
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0