CMS Formulary

Displaying 93981-93990 of 1611142 results.
ID: 93981
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 213284
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93982
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 859865
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93983
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 352297
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93984
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 731328
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93985
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 404460
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93986
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1593140
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93987
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1547575
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 93988
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1547110
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 93989
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243848
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 93990
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243843
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30