CMS Formulary

Displaying 94081-94090 of 1611142 results.
ID: 94081
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 150840
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94082
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 208949
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94083
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 202301
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94084
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000491
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94085
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000497
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94086
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000499
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94087
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000500
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94088
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000487
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94089
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653579
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94090
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 198148
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0