CMS Formulary

Displaying 94111-94120 of 1611142 results.
ID: 94111
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1437969
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94112
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 897657
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1200
Qty Limit Days: 30
ID: 94113
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049604
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1300
Qty Limit Days: 30
ID: 94114
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1874559
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 94115
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1874553
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 94116
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 900575
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94117
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 977427
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94118
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 977434
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94119
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 977438
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94120
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 892625
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30