CMS Formulary

Displaying 94041-94050 of 1611142 results.
ID: 94041
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 762875
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94042
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 762849
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94043
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 762852
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94044
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 762859
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94045
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 762868
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94046
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 762897
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94047
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1009341
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 25
ID: 94048
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1595462
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94049
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1595473
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94050
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1595478
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0