CMS Formulary

Displaying 94381-94390 of 1611142 results.
ID: 94381
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 2110455
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 94382
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 904870
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 94383
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 904876
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 94384
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1314763
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94385
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 309047
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94386
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 312594
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94387
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 198141
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94388
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 834046
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94389
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 834040
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94390
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 197536
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30