CMS Formulary

Displaying 94431-94440 of 1611142 results.
ID: 94431
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 313993
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 94432
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 310293
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 94433
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 310294
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 94434
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 314000
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94435
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 310536
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94436
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 310539
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94437
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1299903
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94438
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 2000695
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94439
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1299909
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94440
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 197507
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0