CMS Formulary

Displaying 94281-94290 of 1611142 results.
ID: 94281
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 2169320
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 94282
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 2362244
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 94283
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1365866
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94284
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1656351
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94285
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1873991
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 94286
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1873993
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 42
Qty Limit Days: 28
ID: 94287
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1873995
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 63
Qty Limit Days: 28
ID: 94288
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1421456
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94289
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923054
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 49
Qty Limit Days: 28
ID: 94290
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801840
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30