CMS Formulary

Displaying 94261-94270 of 1611142 results.
ID: 94261
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1603361
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94262
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1603365
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94263
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1603369
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94264
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1656346
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94265
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1425110
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 94266
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1425118
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 94267
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 867506
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 94268
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1425230
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 94269
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1425228
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 94270
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1245003
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30